Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $313.32 / $313.32 / $313.32	Facility		$313.32	$313.32	$313.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.13 / $268.56 / $358.08	Professional		$210.13	$268.56	$358.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $450.60 / $450.60 / $820.09	Facility		$450.60	$450.60	$820.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.80 / $419.06 / $513.67	Professional		$309.80	$419.06	$513.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $58.58 / $96.43	Facility		$38.90	$58.58	$96.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.68 / $55.22 / $74.20	Professional		$46.68	$55.22	$74.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,288.59 / $1,505.83 / $2,309.98	Facility		$1,288.59	$1,505.83	$2,309.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.57 / $558.75 / $698.44	Professional		$61.57	$558.75	$698.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.32 / $210.13 / $455.90	Facility		$36.32	$210.13	$455.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $41.30 / $41.30 / $58.02	Professional		$41.30	$41.30	$58.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.30 / $312.08 / $5,280.00	Facility		$41.30	$312.08	$5,280.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.17 / $30.98 / $309.77	Professional		$23.17	$30.98	$309.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $50.00 / $70.00	Professional		$0.60	$50.00	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.32 / $211.19 / $455.90	Facility		$36.32	$211.19	$455.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $41.30 / $41.30 / $58.02	Professional		$41.30	$41.30	$58.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.31 / $104.12 / $142.80	Professional		$50.31	$104.12	$142.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $5,280.00 / $5,280.00	Facility		$65.00	$5,280.00	$5,280.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.33 / $61.57 / $102.05	Professional		$34.33	$61.57	$102.05
United Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $30.90 / $63.35	Professional		$17.50	$30.90	$63.35