Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $746.13 / $746.13 / $746.13	Facility		$746.13	$746.13	$746.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.73 / $615.64 / $771.03	Professional		$416.73	$615.64	$771.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,119.80 / $2,038.04 / $2,038.04	Facility		$1,119.80	$2,038.04	$2,038.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $608.02 / $1,041.41 / $1,399.75	Professional		$608.02	$1,041.41	$1,399.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.56 / $80.56 / $239.64	Facility		$80.56	$80.56	$239.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $687.90 / $687.90 / $3,133.44	Facility		$687.90	$687.90	$3,133.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $584.72 / $1,188.75 / $1,485.94	Professional		$584.72	$1,188.75	$1,485.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $62.24 / $306.58 / $1,119.20	Facility		$62.24	$306.58	$1,119.20
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $134.38 / $134.38 / $433.16	Professional		$134.38	$134.38	$433.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.67 / $878.83 / $5,025.03	Facility		$102.67	$878.83	$5,025.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $361.76 / $527.29 / $932.96	Professional		$361.76	$527.29	$932.96
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 $67.19 / $530.30 / $1,119.20	Facility		$67.19	$530.30	$1,119.20
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $134.38 / $134.38 / $433.16	Professional		$134.38	$134.38	$433.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.76 / $224.02 / $290.87	Professional		$125.76	$224.02	$290.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $622.72 / $1,808.80 / $5,025.03	Facility		$622.72	$1,808.80	$5,025.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.87 / $687.90 / $687.90	Professional		$76.87	$687.90	$687.90
United Facility/Professional Professional Modifier Low / Median / High Price $361.76 / $527.29 / $932.96	Professional		$361.76	$527.29	$932.96