Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $582.82 / $582.82 / $582.82	Facility		$582.82	$582.82	$582.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $372.49 / $528.19 / $698.94	Professional		$372.49	$528.19	$698.94
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 $639.16 / $687.27 / $997.65	Professional		$639.16	$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 $545.00 / $574.53 / $3,107.03	Facility		$545.00	$574.53	$3,107.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $463.25 / $866.25 / $1,082.81	Professional		$463.25	$866.25	$1,082.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.99 / $487.13 / $874.23	Facility		$84.99	$487.13	$874.23
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $688.35 / $688.35	Professional		$88.68	$688.35	$688.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.99 / $989.50 / $3,720.55	Facility		$84.99	$989.50	$3,720.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $431.49 / $601.96 / $941.53	Professional		$431.49	$601.96	$941.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.41 / $58.40 / $578.67	Professional		$1.41	$58.40	$578.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $84.99 / $582.82 / $874.23	Facility		$84.99	$582.82	$874.23
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $88.68 / $688.35 / $688.35	Professional		$88.68	$688.35	$688.35
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 $545.00 / $1,339.24 / $3,720.55	Facility		$545.00	$1,339.24	$3,720.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.58 / $545.00 / $545.00	Professional		$59.58	$545.00	$545.00
United Facility/Professional Professional Modifier Low / Median / High Price $390.41 / $555.02 / $965.71	Professional		$390.41	$555.02	$965.71