Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $260.89 / $260.89 / $260.89	Facility		$260.89	$260.89	$260.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.09 / $200.59 / $308.61	Professional		$140.09	$200.59	$308.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $391.60 / $712.71 / $712.71	Facility		$391.60	$712.71	$712.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $311.26 / $364.19 / $481.66	Professional		$311.26	$364.19	$481.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.17 / $28.17 / $83.80	Facility		$28.17	$28.17	$83.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $240.50 / $240.50 / $1,013.76	Facility		$240.50	$240.50	$1,013.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.43 / $386.25 / $482.81	Professional		$204.43	$386.25	$482.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.50 / $107.19 / $391.34	Facility		$23.50	$107.19	$391.34
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $46.99 / $46.99 / $202.29	Professional		$46.99	$46.99	$202.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.58 / $290.98 / $1,757.61	Facility		$28.58	$290.98	$1,757.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.40 / $184.43 / $326.13	Professional		$126.40	$184.43	$326.13
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 $23.50 / $107.19 / $391.34	Facility		$23.50	$107.19	$391.34
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $46.99 / $46.99 / $202.29	Professional		$46.99	$46.99	$202.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.98 / $78.09 / $101.40	Professional		$43.98	$78.09	$101.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $240.50 / $632.66 / $1,757.61	Facility		$240.50	$632.66	$1,757.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $240.50 / $240.50	Professional		$26.88	$240.50	$240.50
United Facility/Professional Professional Modifier Low / Median / High Price $126.40 / $187.17 / $326.13	Professional		$126.40	$187.17	$326.13