Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $852.04 / $852.04 / $852.04	Facility		$852.04	$852.04	$852.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $576.71 / $698.61 / $1,080.18	Professional		$576.71	$698.61	$1,080.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,278.80 / $2,327.42 / $2,327.42	Facility		$1,278.80	$2,327.42	$2,327.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $744.13 / $1,189.28 / $1,572.92	Professional		$744.13	$1,189.28	$1,572.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $92.01 / $92.01 / $273.66	Facility		$92.01	$92.01	$273.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $359.59 / $359.59 / $3,553.28	Facility		$359.59	$359.59	$3,553.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.64 / $1,350.00 / $1,687.50	Professional		$305.64	$1,350.00	$1,687.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $82.24 / $375.26 / $1,290.84	Facility		$82.24	$375.26	$1,290.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $153.46 / $153.46 / $530.42	Professional		$153.46	$153.46	$530.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $116.50 / $1,075.71 / $6,150.76	Facility		$116.50	$1,075.71	$6,150.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $442.70 / $645.37 / $1,141.66	Professional		$442.70	$645.37	$1,141.66
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 $82.24 / $648.91 / $1,290.84	Facility		$82.24	$648.91	$1,290.84
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $153.46 / $153.46 / $530.42	Professional		$153.46	$153.46	$530.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $143.61 / $273.70 / $355.40	Professional		$143.61	$273.70	$355.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $359.59 / $2,214.00 / $6,150.76	Facility		$359.59	$2,214.00	$6,150.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $94.09 / $359.59 / $359.59	Professional		$94.09	$359.59	$359.59
United Facility/Professional Professional Modifier Low / Median / High Price $442.70 / $645.42 / $1,124.04	Professional		$442.70	$645.42	$1,124.04