Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $442.33 / $442.33 / $442.33	Facility		$442.33	$442.33	$442.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.32 / $338.37 / $523.16	Professional		$279.32	$338.37	$523.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $663.90 / $1,208.30 / $1,208.30	Facility		$663.90	$1,208.30	$1,208.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.42 / $617.42 / $816.59	Professional		$360.42	$617.42	$816.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.76 / $47.76 / $142.07	Facility		$47.76	$47.76	$142.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.81 / $407.81 / $1,720.32	Facility		$407.81	$407.81	$1,720.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.64 / $652.50 / $815.63	Professional		$346.64	$652.50	$815.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.83 / $181.71 / $663.50	Facility		$39.83	$181.71	$663.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $79.67 / $79.67 / $256.80	Professional		$79.67	$79.67	$256.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.43 / $520.98 / $2,978.91	Facility		$56.43	$520.98	$2,978.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $214.39 / $312.54 / $552.83	Professional		$214.39	$312.54	$552.83
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 $39.83 / $314.11 / $663.50	Facility		$39.83	$314.11	$663.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $79.67 / $79.67 / $256.80	Professional		$79.67	$79.67	$256.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.55 / $132.52 / $172.07	Professional		$74.55	$132.52	$172.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $369.06 / $1,072.28 / $2,978.91	Facility		$369.06	$1,072.28	$2,978.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.24 / $407.81 / $407.81	Professional		$47.24	$407.81	$407.81
United Facility/Professional Professional Modifier Low / Median / High Price $208.74 / $279.33 / $520.98	Professional		$208.74	$279.33	$520.98