Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $899.92 / $899.92 / $899.92	Facility		$899.92	$899.92	$899.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $565.50 / $809.93 / $1,061.46	Professional		$565.50	$809.93	$1,061.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,354.80 / $2,465.73 / $2,465.73	Facility		$1,354.80	$2,465.73	$2,465.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,014.01 / $1,259.96 / $1,693.50	Professional		$1,014.01	$1,259.96	$1,693.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.51 / $99.10 / $294.76	Facility		$95.51	$99.10	$294.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $833.40 / $833.40 / $3,622.50	Facility		$833.40	$833.40	$3,622.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $708.39 / $1,571.25 / $1,964.06	Professional		$708.39	$1,571.25	$1,964.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $777.78 / $1,143.79 / $1,619.86	Facility		$777.78	$1,143.79	$1,619.86
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $915.03 / $915.03 / $1,625.76	Professional		$915.03	$915.03	$1,625.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $777.78 / $1,354.80 / $7,110.09	Facility		$777.78	$1,354.80	$7,110.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $574.35 / $783.21 / $1,671.45	Professional		$574.35	$783.21	$1,671.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $1,119.80	Professional		$50.00	$90.00	$1,119.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $777.78 / $1,165.85 / $1,619.86	Facility		$777.78	$1,165.85	$1,619.86
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $915.03 / $915.03 / $1,625.76	Professional		$915.03	$915.03	$1,625.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $151.27 / $317.10 / $411.73	Professional		$151.27	$317.10	$411.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $833.40 / $2,559.32 / $7,110.09	Facility		$833.40	$2,559.32	$7,110.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.49 / $833.40 / $833.40	Professional		$106.49	$833.40	$833.40
United Facility/Professional Professional Modifier Low / Median / High Price $526.16 / $780.01 / $1,614.56	Professional		$526.16	$780.01	$1,614.56