Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $607.80 / $607.80 / $607.80	Facility		$607.80	$607.80	$607.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $382.79 / $542.92 / $718.29	Professional		$382.79	$542.92	$718.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $739.00 / $812.90 / $1,344.98	Facility		$739.00	$812.90	$1,344.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $604.86 / $687.27 / $923.75	Professional		$604.86	$687.27	$923.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.10 / $158.15 / $158.15	Facility		$52.10	$158.15	$158.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $568.02 / $695.55 / $3,107.03	Facility		$568.02	$695.55	$3,107.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $482.82 / $866.25 / $1,082.81	Professional		$482.82	$866.25	$1,082.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.99 / $523.79 / $911.72	Facility		$84.99	$523.79	$911.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $740.19 / $740.19	Professional		$88.68	$740.19	$740.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.99 / $1,064.15 / $3,720.55	Facility		$84.99	$1,064.15	$3,720.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $464.09 / $647.44 / $1,012.67	Professional		$464.09	$647.44	$1,012.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.29 / $58.40 / $531.36	Professional		$1.29	$58.40	$531.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $84.99 / $607.80 / $911.72	Facility		$84.99	$607.80	$911.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $740.19 / $740.19	Professional		$88.68	$740.19	$740.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.51 / $165.65 / $215.08	Professional		$82.51	$165.65	$215.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $568.02 / $1,339.24 / $3,720.55	Facility		$568.02	$1,339.24	$3,720.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.58 / $568.02 / $695.55	Professional		$59.58	$568.02	$695.55
United Facility/Professional Professional Modifier Low / Median / High Price $415.98 / $581.19 / $1,038.69	Professional		$415.98	$581.19	$1,038.69