Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $997.43 / $997.43 / $997.43	Facility		$997.43	$997.43	$997.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $629.89 / $922.22 / $1,179.81	Professional		$629.89	$922.22	$1,179.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,497.10 / $2,724.72 / $2,724.72	Facility		$1,497.10	$2,724.72	$2,724.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $956.33 / $1,392.30 / $1,871.37	Professional		$956.33	$1,392.30	$1,871.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $107.70 / $107.70 / $320.38	Facility		$107.70	$107.70	$320.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $469.00 / $469.00 / $4,628.47	Facility		$469.00	$469.00	$4,628.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.65 / $1,758.75 / $2,198.44	Professional		$398.65	$1,758.75	$2,198.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $103.91 / $482.22 / $1,658.60	Facility		$103.91	$482.22	$1,658.60
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $179.65 / $179.65 / $681.41	Professional		$179.65	$179.65	$681.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $149.71 / $1,382.17 / $7,903.07	Facility		$149.71	$1,382.17	$7,903.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $568.91 / $829.30 / $1,466.93	Professional		$568.91	$829.30	$1,466.93
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 $105.68 / $834.06 / $1,658.60	Facility		$105.68	$834.06	$1,658.60
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $179.65 / $179.65 / $681.41	Professional		$179.65	$179.65	$681.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $168.13 / $351.80 / $456.79	Professional		$168.13	$351.80	$456.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $469.00 / $2,844.76 / $7,903.07	Facility		$469.00	$2,844.76	$7,903.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.90 / $469.00 / $469.00	Professional		$120.90	$469.00	$469.00
United Facility/Professional Professional Modifier Low / Median / High Price $568.91 / $841.90 / $1,501.30	Professional		$568.91	$841.90	$1,501.30