Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,651.93 / $1,651.93 / $1,651.93	Facility		$1,651.93	$1,651.93	$1,651.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,067.11 / $1,518.24 / $2,003.04	Professional		$1,067.11	$1,518.24	$2,003.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,461.30 / $2,707.43 / $4,479.57	Facility		$2,461.30	$2,707.43	$4,479.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,217.77 / $2,289.01 / $3,027.39	Professional		$1,217.77	$2,289.01	$3,027.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $176.93 / $526.72 / $526.72	Facility		$176.93	$526.72	$526.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.19 / $211.75 / $10,594.70	Facility		$144.19	$211.75	$10,594.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.19 / $2,951.25 / $3,689.06	Professional		$144.19	$2,951.25	$3,689.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $148.96 / $808.16 / $2,483.63	Facility		$148.96	$808.16	$2,483.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $155.46 / $155.46 / $295.36	Professional		$155.46	$155.46	$295.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $2,069.69 / $11,834.20	Facility		$147.68	$2,069.69	$11,834.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $757.51 / $1,050.89 / $1,660.88	Professional		$757.51	$1,050.89	$1,660.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $152.66 / $808.16 / $2,649.20	Facility		$152.66	$808.16	$2,649.20
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $155.46 / $155.46 / $295.36	Professional		$155.46	$155.46	$295.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $276.41 / $527.71 / $685.19	Professional		$276.41	$527.71	$685.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $2,595.23 / $11,834.20	Facility		$65.00	$2,595.23	$11,834.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.19 / $144.19 / $211.75	Professional		$144.19	$144.19	$211.75
United Facility/Professional Professional Modifier Low / Median / High Price $642.24 / $900.76 / $1,660.88	Professional		$642.24	$900.76	$1,660.88