Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $879.27 / $879.27 / $879.27	Facility		$879.27	$879.27	$879.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $516.40 / $795.00 / $1,004.88	Professional		$516.40	$795.00	$1,004.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $967.00 / $967.00 / $1,759.94	Facility		$967.00	$967.00	$1,759.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $700.20 / $899.31 / $1,102.38	Professional		$700.20	$899.31	$1,102.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.06 / $206.94 / $206.94	Facility		$65.06	$206.94	$206.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,604.23 / $3,043.26 / $4,668.43	Facility		$2,604.23	$3,043.26	$4,668.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $259.80 / $4,199.31 / $5,096.25	Professional		$259.80	$4,199.31	$5,096.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $93.86 / $427.07 / $1,224.04	Facility		$93.86	$427.07	$1,224.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $116.04 / $159.41 / $159.41	Professional		$116.04	$159.41	$159.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.70 / $199.28 / $1,073.03	Facility		$96.70	$199.28	$1,073.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.71 / $103.99 / $199.28	Professional		$50.71	$103.99	$199.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $90.00	Professional		$50.00	$58.40	$90.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $89.68 / $456.50 / $1,230.98	Facility		$89.68	$456.50	$1,230.98
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $116.04 / $159.41 / $159.41	Professional		$116.04	$159.41	$159.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.97 / $215.34 / $295.33	Professional		$107.97	$215.34	$295.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $199.28 / $199.28	Facility		$65.00	$199.28	$199.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.76 / $71.76 / $191.10	Professional		$71.76	$71.76	$191.10
United Facility/Professional Professional Modifier Low / Median / High Price $41.68 / $79.23 / $199.28	Professional		$41.68	$79.23	$199.28