Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $959.14 / $959.14 / $959.14	Facility		$959.14	$959.14	$959.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $605.65 / $822.65 / $1,134.45	Professional		$605.65	$822.65	$1,134.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,439.50 / $2,619.89 / $2,619.89	Facility		$1,439.50	$2,619.89	$2,619.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $781.38 / $1,338.74 / $1,799.37	Professional		$781.38	$1,338.74	$1,799.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.56 / $103.56 / $308.05	Facility		$103.56	$103.56	$308.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $4,188.16	Facility		$200.00	$200.00	$4,188.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.81 / $1,590.00 / $1,987.50	Professional		$98.81	$1,590.00	$1,987.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $86.37 / $394.07 / $1,438.71	Facility		$86.37	$394.07	$1,438.71
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $172.74 / $172.74 / $556.88	Professional		$172.74	$172.74	$556.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $137.19 / $1,129.57 / $6,458.74	Facility		$137.19	$1,129.57	$6,458.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $464.84 / $615.98 / $1,199.08	Professional		$464.84	$615.98	$1,199.08
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 $86.37 / $681.55 / $1,438.71	Facility		$86.37	$681.55	$1,438.71
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $172.74 / $172.74 / $556.88	Professional		$172.74	$172.74	$556.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $161.66 / $287.91 / $373.83	Professional		$161.66	$287.91	$373.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $2,324.86 / $6,458.74	Facility		$200.00	$2,324.86	$6,458.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $98.81 / $200.00 / $200.00	Professional		$98.81	$200.00	$200.00
United Facility/Professional Professional Modifier Low / Median / High Price $464.84 / $615.98 / $1,180.32	Professional		$464.84	$615.98	$1,180.32