Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,169.42 / $1,169.42 / $1,169.42	Facility		$1,169.42	$1,169.42	$1,169.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $627.72 / $894.60 / $1,206.08	Professional		$627.72	$894.60	$1,206.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,755.10 / $3,194.28 / $3,194.28	Facility		$1,755.10	$3,194.28	$3,194.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $961.80 / $1,632.24 / $2,193.87	Professional		$961.80	$1,632.24	$2,193.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.27 / $126.27 / $375.59	Facility		$126.27	$126.27	$375.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,009.98 / $4,556.80 / $7,188.42	Facility		$4,009.98	$4,556.80	$7,188.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.05 / $1,728.75 / $2,160.94	Professional		$124.05	$1,728.75	$2,160.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.57 / $480.56 / $1,754.13	Facility		$104.57	$480.56	$1,754.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $210.61 / $210.61 / $679.27	Professional		$210.61	$210.61	$679.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $149.18 / $1,377.21 / $7,874.71	Facility		$149.18	$1,377.21	$7,874.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $566.95 / $826.33 / $1,461.79	Professional		$566.95	$826.33	$1,461.79
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 $105.30 / $830.92 / $1,754.13	Facility		$105.30	$830.92	$1,754.13
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $210.61 / $210.61 / $679.27	Professional		$210.61	$210.61	$679.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $197.11 / $351.02 / $455.77	Professional		$197.11	$351.02	$455.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $976.17 / $2,834.56 / $7,874.71	Facility		$976.17	$2,834.56	$7,874.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.05 / $124.05 / $1,223.23	Professional		$124.05	$124.05	$1,223.23
United Facility/Professional Professional Modifier Low / Median / High Price $566.95 / $708.28 / $1,461.79	Professional		$566.95	$708.28	$1,461.79