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 / $1,666.40	Professional		$1,014.01	$1,259.96	$1,666.40
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 $795.00 / $795.00 / $3,622.50	Facility		$795.00	$795.00	$3,622.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $675.75 / $1,571.25 / $1,964.06	Professional		$675.75	$1,571.25	$1,964.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $110.19 / $839.00 / $1,492.19	Facility		$110.19	$839.00	$1,492.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $165.29 / $165.29 / $165.29	Professional		$165.29	$165.29	$165.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $98.66 / $1,243.49 / $7,110.09	Facility		$98.66	$1,243.49	$7,110.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $524.80 / $741.65 / $1,614.56	Professional		$524.80	$741.65	$1,614.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $1,119.80	Professional		$50.00	$58.40	$1,119.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $110.19 / $899.92 / $1,492.19	Facility		$110.19	$899.92	$1,492.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $165.29 / $165.29 / $165.29	Professional		$165.29	$165.29	$165.29
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 $76.00 / $2,559.32 / $7,110.09	Facility		$76.00	$2,559.32	$7,110.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.49 / $795.00 / $810.90	Professional		$106.49	$795.00	$810.90
United Facility/Professional Professional Modifier Low / Median / High Price $526.16 / $668.58 / $1,538.84	Professional		$526.16	$668.58	$1,538.84