Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $624.61 / $624.61 / $624.61	Facility		$624.61	$624.61	$624.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $464.04 / $624.61 / $738.81	Professional		$464.04	$624.61	$738.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.60 / $1,706.43 / $1,706.43	Facility		$937.60	$1,706.43	$1,706.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $598.82 / $871.97 / $1,172.00	Professional		$598.82	$871.97	$1,172.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.44 / $67.44 / $200.65	Facility		$67.44	$67.44	$200.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,856.55 / $3,246.08 / $5,120.74	Facility		$2,856.55	$3,246.08	$5,120.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.70 / $1,233.75 / $1,542.19	Professional		$75.70	$1,233.75	$1,542.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.49 / $301.95 / $1,038.61	Facility		$63.49	$301.95	$1,038.61
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $112.51 / $112.51 / $426.74	Professional		$112.51	$112.51	$426.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.76 / $865.52 / $4,948.92	Facility		$93.76	$865.52	$4,948.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $356.28 / $512.19 / $918.81	Professional		$356.28	$512.19	$918.81
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 $66.18 / $522.15 / $1,038.61	Facility		$66.18	$522.15	$1,038.61
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $112.51 / $112.51 / $426.74	Professional		$112.51	$112.51	$426.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $105.28 / $220.86 / $286.77	Professional		$105.28	$220.86	$286.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $613.20 / $1,781.40 / $4,948.92	Facility		$613.20	$1,781.40	$4,948.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.70 / $75.70 / $768.75	Professional		$75.70	$75.70	$768.75
United Facility/Professional Professional Modifier Low / Median / High Price $356.28 / $464.10 / $865.52	Professional		$356.28	$464.10	$865.52