Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $879.27 / $879.27 / $879.27	Facility		$879.27	$879.27	$879.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $516.40 / $795.00 / $1,004.88	Professional		$516.40	$795.00	$1,004.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $967.00 / $967.00 / $1,759.94	Facility		$967.00	$967.00	$1,759.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $700.20 / $899.31 / $1,141.06	Professional		$700.20	$899.31	$1,141.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.06 / $206.94 / $206.94	Facility		$65.06	$206.94	$206.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,604.23 / $3,043.26 / $4,668.43	Facility		$2,604.23	$3,043.26	$4,668.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $750.60 / $4,077.00 / $5,096.25	Professional		$750.60	$4,077.00	$5,096.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $93.86 / $753.66 / $1,318.91	Facility		$93.86	$753.66	$1,318.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $116.04 / $159.41 / $159.41	Professional		$116.04	$159.41	$159.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.68 / $858.36 / $4,832.10	Facility		$89.68	$858.36	$4,832.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.85 / $106.42 / $3,860.46	Professional		$60.85	$106.42	$3,860.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $90.00	Professional		$50.00	$58.40	$90.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $89.68 / $795.00 / $1,318.91	Facility		$89.68	$795.00	$1,318.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $116.04 / $159.41 / $159.41	Professional		$116.04	$159.41	$159.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.97 / $215.34 / $295.33	Professional		$107.97	$215.34	$295.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $1,739.34 / $4,832.10	Facility		$65.00	$1,739.34	$4,832.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $79.45 / $750.60 / $4,687.97	Professional		$79.45	$750.60	$4,687.97
United Facility/Professional Professional Modifier Low / Median / High Price $60.85 / $104.21 / $1,056.35	Professional		$60.85	$104.21	$1,056.35