Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.59 / $1,174.59 / $1,174.59	Facility		$1,174.59	$1,174.59	$1,174.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $632.26 / $1,060.09 / $1,184.22	Professional		$632.26	$1,060.09	$1,184.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,762.90 / $3,208.48 / $3,208.48	Facility		$1,762.90	$3,208.48	$3,208.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $846.26 / $1,639.50 / $2,203.62	Professional		$846.26	$1,639.50	$2,203.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.83 / $126.83 / $377.26	Facility		$126.83	$126.83	$377.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,748.89 / $5,396.48 / $8,513.03	Facility		$4,748.89	$5,396.48	$8,513.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,232.30 / $2,051.25 / $2,564.06	Professional		$1,232.30	$2,051.25	$2,564.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $106.07 / $483.89 / $1,761.90	Facility		$106.07	$483.89	$1,761.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $211.55 / $211.55 / $683.81	Professional		$211.55	$211.55	$683.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $176.29 / $1,387.43 / $7,933.12	Facility		$176.29	$1,387.43	$7,933.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $570.87 / $778.07 / $1,472.51	Professional		$570.87	$778.07	$1,472.51
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 $106.07 / $836.88 / $1,761.90	Facility		$106.07	$836.88	$1,761.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $211.55 / $211.55 / $683.81	Professional		$211.55	$211.55	$683.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $197.98 / $353.38 / $458.84	Professional		$197.98	$353.38	$458.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $983.03 / $2,855.58 / $7,933.12	Facility		$983.03	$2,855.58	$7,933.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.95 / $124.95 / $1,232.30	Professional		$124.95	$124.95	$1,232.30
United Facility/Professional Professional Modifier Low / Median / High Price $570.87 / $744.02 / $1,472.51	Professional		$570.87	$744.02	$1,472.51