Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $328.51 / $328.51 / $328.51	Facility		$328.51	$328.51	$328.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.19 / $303.72 / $371.61	Professional		$201.19	$303.72	$371.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $481.20 / $875.78 / $875.78	Facility		$481.20	$875.78	$875.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.90 / $447.52 / $601.50	Professional		$360.90	$447.52	$601.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.93 / $102.98 / $116.16	Facility		$33.93	$102.98	$116.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $256.50 / $256.50 / $1,252.56	Facility		$256.50	$256.50	$1,252.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.03 / $543.75 / $679.69	Professional		$218.03	$543.75	$679.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $50.52 / $274.00 / $492.77	Facility		$50.52	$274.00	$492.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $65.14 / $65.14 / $244.24	Professional		$65.14	$65.14	$244.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.28 / $351.16 / $1,497.41	Facility		$54.28	$351.16	$1,497.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $159.44 / $231.80 / $364.64	Professional		$159.44	$231.80	$364.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $0.62 / $58.40 / $257.21	Professional		$0.62	$58.40	$257.21
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $50.52 / $299.04 / $492.77	Facility		$50.52	$299.04	$492.77
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $65.14 / $65.14 / $244.24	Professional		$65.14	$65.14	$244.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $53.72 / $98.60 / $128.03	Professional		$53.72	$98.60	$128.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $256.50 / $539.00 / $1,497.41	Facility		$256.50	$539.00	$1,497.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.83 / $256.50 / $386.04	Professional		$35.83	$256.50	$386.04
United Facility/Professional Professional Modifier Low / Median / High Price $157.13 / $214.34 / $412.35	Professional		$157.13	$214.34	$412.35