Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,127.70 / $1,127.70 / $1,127.70	Facility		$1,127.70	$1,127.70	$1,127.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $675.24 / $1,014.93 / $1,274.31	Professional		$675.24	$1,014.93	$1,274.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,559.00 / $1,714.90 / $2,837.38	Facility		$1,559.00	$1,714.90	$2,837.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,057.75 / $1,449.87 / $1,917.57	Professional		$1,057.75	$1,449.87	$1,917.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.91 / $333.63 / $333.63	Facility		$109.91	$333.63	$333.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $989.22 / $4,163.17 / $6,465.99	Facility		$989.22	$4,163.17	$6,465.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $751.21 / $1,807.50 / $2,259.38	Professional		$751.21	$1,807.50	$2,259.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.76 / $679.28 / $1,790.47	Facility		$120.76	$679.28	$1,790.47
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $187.08 / $960.11 / $960.11	Professional		$187.08	$960.11	$960.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $155.90 / $1,557.34 / $8,531.40	Facility		$155.90	$1,557.34	$8,531.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $659.91 / $915.02 / $1,552.21	Professional		$659.91	$915.02	$1,552.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.50 / $58.40 / $1,025.24	Professional		$2.50	$58.40	$1,025.24
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $120.76 / $1,127.70 / $1,909.84	Facility		$120.76	$1,127.70	$1,909.84
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $187.08 / $960.11 / $960.11	Professional		$187.08	$960.11	$960.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $174.06 / $380.20 / $493.66	Professional		$174.06	$380.20	$493.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $989.22 / $2,307.66 / $8,531.40	Facility		$989.22	$2,307.66	$8,531.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $122.53 / $989.22 / $989.22	Professional		$122.53	$989.22	$989.22
United Facility/Professional Professional Modifier Low / Median / High Price $539.91 / $895.24 / $1,492.06	Professional		$539.91	$895.24	$1,492.06