Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.10 / $912.10 / $912.10	Facility		$912.10	$912.10	$912.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.95 / $820.89 / $917.01	Professional		$575.95	$820.89	$917.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,369.00 / $2,491.58 / $2,491.58	Facility		$1,369.00	$2,491.58	$2,491.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $743.01 / $1,273.17 / $1,711.25	Professional		$743.01	$1,273.17	$1,711.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.48 / $98.48 / $292.97	Facility		$98.48	$98.48	$292.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $840.94 / $840.94 / $4,177.92	Facility		$840.94	$840.94	$4,177.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $714.80 / $1,586.25 / $1,982.81	Professional		$714.80	$1,586.25	$1,982.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $82.14 / $374.67 / $1,368.15	Facility		$82.14	$374.67	$1,368.15
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $164.28 / $164.28 / $529.62	Professional		$164.28	$164.28	$529.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $130.26 / $1,074.47 / $6,143.69	Facility		$130.26	$1,074.47	$6,143.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $441.92 / $644.37 / $1,139.95	Professional		$441.92	$644.37	$1,139.95
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 $82.14 / $647.98 / $1,368.15	Facility		$82.14	$647.98	$1,368.15
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $164.28 / $164.28 / $529.62	Professional		$164.28	$164.28	$529.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $153.74 / $273.70 / $355.40	Professional		$153.74	$273.70	$355.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $760.98 / $2,211.46 / $6,143.69	Facility		$760.98	$2,211.46	$6,143.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $96.75 / $840.94 / $840.94	Professional		$96.75	$840.94	$840.94
United Facility/Professional Professional Modifier Low / Median / High Price $441.92 / $644.37 / $1,074.47	Professional		$441.92	$644.37	$1,074.47