Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $313.32 / $313.32 / $313.32	Facility		$313.32	$313.32	$313.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.13 / $290.94 / $358.08	Professional		$210.13	$290.94	$358.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $450.60 / $450.60 / $820.09	Facility		$450.60	$450.60	$820.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $332.43 / $419.06 / $513.67	Professional		$332.43	$419.06	$513.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.31 / $96.43 / $103.47	Facility		$30.31	$96.43	$103.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,288.59 / $1,505.83 / $2,309.98	Facility		$1,288.59	$1,505.83	$2,309.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.54 / $575.51 / $698.44	Professional		$62.54	$575.51	$698.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $59.37 / $211.19 / $455.90	Facility		$59.37	$211.19	$455.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $105.38 / $105.38 / $105.38	Professional		$105.38	$105.38	$105.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.48 / $92.21 / $396.80	Facility		$69.48	$92.21	$396.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.17 / $30.98 / $55.96	Professional		$23.17	$30.98	$55.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $71.46	Professional		$50.00	$58.40	$71.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $58.02 / $211.19 / $455.90	Facility		$58.02	$211.19	$455.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $105.38 / $105.38 / $105.38	Professional		$105.38	$105.38	$105.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.31 / $104.12 / $142.80	Professional		$50.31	$104.12	$142.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $80.00	Facility		$65.00	$65.00	$80.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.33 / $34.33 / $92.40	Professional		$34.33	$34.33	$92.40
United Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $28.14 / $54.78	Professional		$17.50	$28.14	$54.78