Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $732.97 / $732.97 / $732.97	Facility		$732.97	$732.97	$732.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.45 / $576.03 / $866.97	Professional		$393.45	$576.03	$866.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,100.09 / $2,002.18 / $2,002.18	Facility		$1,100.09	$2,002.18	$2,002.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $610.79 / $1,023.09 / $1,375.12	Professional		$610.79	$1,023.09	$1,375.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.15 / $79.15 / $235.42	Facility		$79.15	$79.15	$235.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,514.12 / $2,856.96 / $4,506.89	Facility		$2,514.12	$2,856.96	$4,506.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.52 / $1,083.75 / $1,354.69	Professional		$75.52	$1,083.75	$1,354.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $66.01 / $301.19 / $1,099.46	Facility		$66.01	$301.19	$1,099.46
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $132.01 / $132.01 / $425.68	Professional		$132.01	$132.01	$425.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.51 / $863.35 / $4,936.52	Facility		$93.51	$863.35	$4,936.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $355.30 / $518.01 / $916.24	Professional		$355.30	$518.01	$916.24
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 $66.01 / $520.89 / $1,099.46	Facility		$66.01	$520.89	$1,099.46
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $132.01 / $132.01 / $425.68	Professional		$132.01	$132.01	$425.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.54 / $220.08 / $285.75	Professional		$123.54	$220.08	$285.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $611.67 / $1,776.94 / $4,936.52	Facility		$611.67	$1,776.94	$4,936.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.52 / $75.52 / $766.82	Professional		$75.52	$75.52	$766.82
United Facility/Professional Professional Modifier Low / Median / High Price $355.30 / $462.96 / $916.24	Professional		$355.30	$462.96	$916.24