Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $606.69 / $606.69 / $606.69	Facility		$606.69	$606.69	$606.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $376.53 / $539.03 / $706.50	Professional		$376.53	$539.03	$706.50
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 $628.15 / $687.27 / $997.65	Professional		$628.15	$687.27	$997.65
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 $552.13 / $589.42 / $3,107.03	Facility		$552.13	$589.42	$3,107.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $469.31 / $866.25 / $1,082.81	Professional		$469.31	$866.25	$1,082.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.99 / $499.73 / $910.04	Facility		$84.99	$499.73	$910.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $706.26 / $706.26	Professional		$88.68	$706.26	$706.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.99 / $1,015.02 / $3,720.55	Facility		$84.99	$1,015.02	$3,720.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $442.49 / $617.29 / $965.52	Professional		$442.49	$617.29	$965.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.47 / $58.40 / $605.98	Professional		$1.47	$58.40	$605.98
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $84.99 / $606.69 / $910.04	Facility		$84.99	$606.69	$910.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $706.26 / $706.26	Professional		$88.68	$706.26	$706.26
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 $552.13 / $1,339.24 / $3,720.55	Facility		$552.13	$1,339.24	$3,720.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.71 / $552.13 / $552.13	Professional		$59.71	$552.13	$552.13
United Facility/Professional Professional Modifier Low / Median / High Price $396.90 / $557.04 / $1,027.10	Professional		$396.90	$557.04	$1,027.10