Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $615.02 / $615.02 / $615.02	Facility		$615.02	$615.02	$615.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $388.40 / $553.52 / $702.88	Professional		$388.40	$553.52	$702.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $923.00 / $1,015.30 / $1,679.86	Facility		$923.00	$1,015.30	$1,679.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $784.55 / $858.39 / $1,135.29	Professional		$784.55	$858.39	$1,135.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.41 / $197.52 / $197.52	Facility		$66.41	$197.52	$197.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,478.08 / $2,895.83 / $4,442.28	Facility		$2,478.08	$2,895.83	$4,442.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $643.37 / $1,068.75 / $1,335.94	Professional		$643.37	$1,068.75	$1,335.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.47 / $594.16 / $1,107.04	Facility		$57.47	$594.16	$1,107.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $92.30 / $110.76 / $110.76	Professional		$92.30	$110.76	$110.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.84 / $724.36 / $4,141.80	Facility		$73.84	$724.36	$4,141.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $339.82 / $442.66 / $858.60	Professional		$339.82	$442.66	$858.60
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 $57.47 / $615.02 / $1,107.04	Facility		$57.47	$615.02	$1,107.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $92.30 / $110.76 / $110.76	Professional		$92.30	$110.76	$110.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $100.57 / $184.58 / $239.66	Professional		$100.57	$184.58	$239.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $1,490.86 / $4,141.80	Facility		$65.00	$1,490.86	$4,141.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.25 / $922.05 / $4,018.27	Professional		$65.25	$922.05	$4,018.27
United Facility/Professional Professional Modifier Low / Median / High Price $311.57 / $434.62 / $890.28	Professional		$311.57	$434.62	$890.28