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 $143.10 / $268.56 / $358.08	Professional		$143.10	$268.56	$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 $280.10 / $419.06 / $513.67	Professional		$280.10	$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 $66.81 / $558.75 / $698.44	Professional		$66.81	$558.75	$698.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.07 / $143.85 / $455.90	Facility		$32.07	$143.85	$455.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $25.43 / $25.43 / $58.02	Professional		$25.43	$25.43	$58.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.32 / $80.00 / $358.08	Facility		$36.32	$80.00	$358.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $17.23 / $23.17 / $51.63	Professional		$17.23	$23.17	$51.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $50.00 / $65.00	Professional		$0.60	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $31.61 / $143.85 / $455.90	Facility		$31.61	$143.85	$455.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $25.43 / $25.43 / $58.02	Professional		$25.43	$25.43	$58.02
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 $35.88 / $66.81 / $66.81	Professional		$35.88	$66.81	$66.81
United Facility/Professional Professional Modifier Low / Median / High Price $17.23 / $23.17 / $51.50	Professional		$17.23	$23.17	$51.50