Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.91 / $630.91 / $630.91	Facility		$630.91	$630.91	$630.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $395.06 / $553.39 / $746.28	Professional		$395.06	$553.39	$746.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $946.90 / $1,723.36 / $1,723.36	Facility		$946.90	$1,723.36	$1,723.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $534.79 / $880.62 / $1,183.61	Professional		$534.79	$880.62	$1,183.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.12 / $68.12 / $202.64	Facility		$68.12	$68.12	$202.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,478.08 / $2,816.00 / $4,442.28	Facility		$2,478.08	$2,816.00	$4,442.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $1,068.75 / $1,335.94	Professional		$65.00	$1,068.75	$1,335.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.82 / $259.29 / $946.37	Facility		$56.82	$259.29	$946.37
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $113.63 / $113.63 / $366.36	Professional		$113.63	$113.63	$366.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $92.28 / $742.93 / $4,248.00	Facility		$92.28	$742.93	$4,248.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $305.92 / $434.51 / $788.54	Professional		$305.92	$434.51	$788.54
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 $56.82 / $448.41 / $946.37	Facility		$56.82	$448.41	$946.37
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $113.63 / $113.63 / $366.36	Professional		$113.63	$113.63	$366.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.34 / $189.31 / $245.81	Professional		$106.34	$189.31	$245.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $526.74 / $1,529.10 / $4,248.00	Facility		$526.74	$1,529.10	$4,248.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.00 / $659.87	Professional		$65.00	$65.00	$659.87
United Facility/Professional Professional Modifier Low / Median / High Price $305.92 / $434.51 / $788.54	Professional		$305.92	$434.51	$788.54