Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $885.08 / $885.08 / $885.08	Facility		$885.08	$885.08	$885.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $534.44 / $786.81 / $1,003.05	Professional		$534.44	$786.81	$1,003.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,233.59 / $1,356.96 / $2,245.15	Facility		$1,233.59	$1,356.96	$2,245.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $863.52 / $1,147.25 / $1,517.32	Professional		$863.52	$1,147.25	$1,517.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $86.97 / $263.99 / $263.99	Facility		$86.97	$263.99	$263.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $775.91 / $775.91 / $5,122.39	Facility		$775.91	$775.91	$5,122.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $659.52 / $1,428.75 / $1,785.94	Professional		$659.52	$1,428.75	$1,785.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $95.66 / $538.07 / $1,416.78	Facility		$95.66	$538.07	$1,416.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $148.03 / $760.50 / $760.50	Professional		$148.03	$760.50	$760.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.36 / $1,236.94 / $6,750.76	Facility		$123.36	$1,236.94	$6,750.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $522.67 / $724.79 / $1,229.51	Professional		$522.67	$724.79	$1,229.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.52 / $58.40 / $1,036.80	Professional		$2.52	$58.40	$1,036.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $95.66 / $885.08 / $1,511.23	Facility		$95.66	$885.08	$1,511.23
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $148.03 / $760.50 / $760.50	Professional		$148.03	$760.50	$760.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $137.74 / $300.52 / $390.22	Professional		$137.74	$300.52	$390.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $775.91 / $1,827.90 / $6,750.76	Facility		$775.91	$1,827.90	$6,750.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $659.52 / $775.91 / $775.91	Professional		$659.52	$775.91	$775.91
United Facility/Professional Professional Modifier Low / Median / High Price $427.27 / $705.64 / $1,229.51	Professional		$427.27	$705.64	$1,229.51