Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $922.67 / $922.67 / $922.67	Facility		$922.67	$922.67	$922.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $508.94 / $745.03 / $1,032.39	Professional		$508.94	$745.03	$1,032.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,384.90 / $2,520.52 / $2,520.52	Facility		$1,384.90	$2,520.52	$2,520.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $772.45 / $1,287.96 / $1,731.12	Professional		$772.45	$1,287.96	$1,731.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.63 / $99.63 / $296.37	Facility		$99.63	$99.63	$296.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $450.00 / $3,717.12	Facility		$450.00	$450.00	$3,717.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.50 / $1,410.00 / $1,762.50	Professional		$382.50	$1,410.00	$1,762.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $83.10 / $389.52 / $1,384.01	Facility		$83.10	$389.52	$1,384.01
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $166.19 / $166.19 / $550.47	Professional		$166.19	$166.19	$550.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $121.69 / $1,116.57 / $6,384.41	Facility		$121.69	$1,116.57	$6,384.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $459.56 / $669.94 / $1,185.36	Professional		$459.56	$669.94	$1,185.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $85.38 / $673.71 / $1,384.01	Facility		$85.38	$673.71	$1,384.01
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $166.19 / $166.19 / $550.47	Professional		$166.19	$166.19	$550.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $155.53 / $284.76 / $369.74	Professional		$155.53	$284.76	$369.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $2,298.10 / $6,384.41	Facility		$450.00	$2,298.10	$6,384.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.68 / $450.00 / $450.00	Professional		$97.68	$450.00	$450.00
United Facility/Professional Professional Modifier Low / Median / High Price $447.42 / $598.94 / $1,185.36	Professional		$447.42	$598.94	$1,185.36