Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $609.00 / $609.00 / $609.00	Facility		$609.00	$609.00	$609.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $435.11 / $548.10 / $814.95	Professional		$435.11	$548.10	$814.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $914.00 / $1,663.48 / $1,663.48	Facility		$914.00	$1,663.48	$1,663.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $494.92 / $850.02 / $1,124.22	Professional		$494.92	$850.02	$1,124.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.77 / $65.77 / $195.60	Facility		$65.77	$65.77	$195.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $422.72 / $422.72 / $2,795.52	Facility		$422.72	$422.72	$2,795.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $359.31 / $1,061.25 / $1,326.56	Professional		$359.31	$1,061.25	$1,326.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.56 / $283.14 / $973.99	Facility		$57.56	$283.14	$973.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $109.68 / $109.68 / $400.02	Professional		$109.68	$109.68	$400.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.40 / $811.66 / $4,640.93	Facility		$91.40	$811.66	$4,640.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $333.94 / $466.93 / $861.39	Professional		$333.94	$466.93	$861.39
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 $58.60 / $489.51 / $973.99	Facility		$58.60	$489.51	$973.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $109.68 / $109.68 / $400.02	Professional		$109.68	$109.68	$400.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.65 / $206.67 / $268.33	Professional		$102.65	$206.67	$268.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $422.72 / $1,670.54 / $4,640.93	Facility		$422.72	$1,670.54	$4,640.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $422.72 / $422.72	Professional		$72.20	$422.72	$422.72
United Facility/Professional Professional Modifier Low / Median / High Price $333.94 / $433.70 / $861.39	Professional		$333.94	$433.70	$861.39