Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $642.11 / $642.11 / $642.11	Facility		$642.11	$642.11	$642.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $477.02 / $593.65 / $893.52	Professional		$477.02	$593.65	$893.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $963.80 / $1,754.12 / $1,754.12	Facility		$963.80	$1,754.12	$1,754.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $615.49 / $896.33 / $1,185.47	Professional		$615.49	$896.33	$1,185.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.33 / $69.33 / $206.25	Facility		$69.33	$69.33	$206.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $428.20 / $428.20 / $2,938.88	Facility		$428.20	$428.20	$2,938.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.97 / $1,117.50 / $1,396.88	Professional		$363.97	$1,117.50	$1,396.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $65.36 / $310.41 / $1,067.58	Facility		$65.36	$310.41	$1,067.58
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $115.66 / $115.66 / $438.78	Professional		$115.66	$115.66	$438.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.38 / $889.66 / $5,087.00	Facility		$96.38	$889.66	$5,087.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $366.27 / $531.78 / $944.53	Professional		$366.27	$531.78	$944.53
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 $65.36 / $536.90 / $1,067.58	Facility		$65.36	$536.90	$1,067.58
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $115.66 / $115.66 / $438.78	Professional		$115.66	$115.66	$438.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $108.24 / $226.39 / $293.95	Professional		$108.24	$226.39	$293.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $428.20 / $1,831.10 / $5,087.00	Facility		$428.20	$1,831.10	$5,087.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $77.83 / $428.20 / $428.20	Professional		$77.83	$428.20	$428.20
United Facility/Professional Professional Modifier Low / Median / High Price $366.27 / $533.79 / $944.53	Professional		$366.27	$533.79	$944.53