Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $336.21 / $336.21 / $336.21	Facility		$336.21	$336.21	$336.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.79 / $320.61 / $392.49	Professional		$215.79	$320.61	$392.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $505.00 / $919.10 / $919.10	Facility		$505.00	$919.10	$919.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $428.07 / $469.65 / $631.25	Professional		$428.07	$469.65	$631.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.61 / $108.07 / $110.87	Facility		$35.61	$108.07	$110.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $235.00 / $238.50 / $1,414.76	Facility		$235.00	$238.50	$1,414.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.00 / $615.00 / $768.75	Professional		$235.00	$615.00	$768.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.45 / $166.91 / $540.48	Facility		$41.45	$166.91	$540.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $62.17 / $62.17 / $235.95	Professional		$62.17	$62.17	$235.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.81 / $450.40 / $2,575.35	Facility		$51.81	$450.40	$2,575.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $161.72 / $226.90 / $398.09	Professional		$161.72	$226.90	$398.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $177.60 / $323.63	Professional		$55.00	$177.60	$323.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $48.76 / $288.69 / $540.48	Facility		$48.76	$288.69	$540.48
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $62.17 / $62.17 / $235.95	Professional		$62.17	$62.17	$235.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.38 / $114.38 / $148.51	Professional		$56.38	$114.38	$148.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $235.00 / $564.77 / $2,575.35	Facility		$235.00	$564.77	$2,575.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $235.00 / $238.50 / $238.50	Professional		$235.00	$238.50	$238.50
United Facility/Professional Facility Modifier Low / Median / High Price $21.91 / $153.81 / $254.03	Facility		$21.91	$153.81	$254.03
United Facility/Professional Professional Modifier Low / Median / High Price $148.91 / $215.63 / $390.55	Professional		$148.91	$215.63	$390.55