Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $938.98 / $938.98 / $938.98	Facility		$938.98	$938.98	$938.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $552.27 / $809.42 / $1,216.98	Professional		$552.27	$809.42	$1,216.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,409.30 / $2,564.92 / $2,564.92	Facility		$1,409.30	$2,564.92	$2,564.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $838.37 / $1,310.65 / $1,761.62	Professional		$838.37	$1,310.65	$1,761.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $101.38 / $101.38 / $301.58	Facility		$101.38	$101.38	$301.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.88 / $707.88 / $4,126.72	Facility		$707.88	$707.88	$4,126.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $601.70 / $1,563.75 / $1,954.69	Professional		$601.70	$1,563.75	$1,954.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $84.56 / $422.73 / $1,454.29	Facility		$84.56	$422.73	$1,454.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $169.12 / $169.12 / $597.50	Professional		$169.12	$169.12	$597.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $134.97 / $1,211.91 / $6,929.56	Facility		$134.97	$1,211.91	$6,929.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $498.75 / $697.14 / $1,286.08	Professional		$498.75	$697.14	$1,286.08
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 $92.66 / $731.13 / $1,454.29	Facility		$92.66	$731.13	$1,454.29
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $169.12 / $169.12 / $597.50	Professional		$169.12	$169.12	$597.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $158.27 / $308.42 / $400.46	Professional		$158.27	$308.42	$400.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $707.88 / $2,494.34 / $6,929.56	Facility		$707.88	$2,494.34	$6,929.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.53 / $707.88 / $707.88	Professional		$109.53	$707.88	$707.88
United Facility/Professional Professional Modifier Low / Median / High Price $498.75 / $622.99 / $1,211.91	Professional		$498.75	$622.99	$1,211.91