Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.87 / $891.87 / $891.87	Facility		$891.87	$891.87	$891.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $507.93 / $851.63 / $1,002.33	Professional		$507.93	$851.63	$1,002.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,338.60 / $2,436.25 / $2,436.25	Facility		$1,338.60	$2,436.25	$2,436.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $771.09 / $1,244.90 / $1,673.25	Professional		$771.09	$1,244.90	$1,673.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $96.29 / $96.29 / $286.45	Facility		$96.29	$96.29	$286.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $999.36 / $999.36 / $4,341.76	Facility		$999.36	$999.36	$4,341.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $849.46 / $1,646.25 / $2,057.81	Professional		$849.46	$1,646.25	$2,057.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $80.31 / $388.85 / $1,337.81	Facility		$80.31	$388.85	$1,337.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $160.63 / $160.63 / $549.66	Professional		$160.63	$160.63	$549.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.86 / $1,114.40 / $6,372.01	Facility		$133.86	$1,114.40	$6,372.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $458.77 / $641.87 / $1,182.80	Professional		$458.77	$641.87	$1,182.80
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 $85.22 / $672.45 / $1,337.81	Facility		$85.22	$672.45	$1,337.81
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $160.63 / $160.63 / $549.66	Professional		$160.63	$160.63	$549.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $150.33 / $283.97 / $368.71	Professional		$150.33	$283.97	$368.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $789.92 / $2,293.64 / $6,372.01	Facility		$789.92	$2,293.64	$6,372.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $999.36 / $999.36	Professional		$109.71	$999.36	$999.36
United Facility/Professional Professional Modifier Low / Median / High Price $458.77 / $668.64 / $1,182.80	Professional		$458.77	$668.64	$1,182.80