Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $809.97 / $809.97 / $809.97	Facility		$809.97	$809.97	$809.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $434.75 / $636.54 / $814.32	Professional		$434.75	$636.54	$814.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,215.70 / $2,212.57 / $2,212.57	Facility		$1,215.70	$2,212.57	$2,212.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.00 / $1,130.59 / $1,495.31	Professional		$660.00	$1,130.59	$1,495.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.46 / $87.46 / $260.16	Facility		$87.46	$87.46	$260.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $746.73 / $746.73 / $3,153.92	Facility		$746.73	$746.73	$3,153.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $634.72 / $1,196.25 / $1,495.31	Professional		$634.72	$1,196.25	$1,495.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $72.94 / $332.82 / $1,214.96	Facility		$72.94	$332.82	$1,214.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $145.88 / $145.88 / $470.30	Professional		$145.88	$145.88	$470.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.33 / $954.05 / $5,455.13	Facility		$103.33	$954.05	$5,455.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $392.73 / $572.42 / $1,012.67	Professional		$392.73	$572.42	$1,012.67
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 $72.94 / $575.49 / $1,214.96	Facility		$72.94	$575.49	$1,214.96
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $145.88 / $145.88 / $470.30	Professional		$145.88	$145.88	$470.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $136.53 / $242.95 / $315.45	Professional		$136.53	$242.95	$315.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $676.04 / $1,963.62 / $5,455.13	Facility		$676.04	$1,963.62	$5,455.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.92 / $746.73 / $746.73	Professional		$85.92	$746.73	$746.73
United Facility/Professional Professional Modifier Low / Median / High Price $392.73 / $511.68 / $1,012.67	Professional		$392.73	$511.68	$1,012.67