Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.43 / $794.43 / $794.43	Facility		$794.43	$794.43	$794.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $485.71 / $714.23 / $911.61	Professional		$485.71	$714.23	$911.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,165.09 / $2,120.48 / $2,120.48	Facility		$1,165.09	$2,120.48	$2,120.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $978.38 / $1,083.54 / $1,456.37	Professional		$978.38	$1,083.54	$1,456.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $82.13 / $249.33 / $279.91	Facility		$82.13	$249.33	$279.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.69 / $251.69 / $3,108.86	Facility		$251.69	$251.69	$3,108.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.94 / $1,350.00 / $1,687.50	Professional		$213.94	$1,350.00	$1,687.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $104.64 / $376.02 / $1,191.65	Facility		$104.64	$376.02	$1,191.65
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $156.96 / $156.96 / $156.96	Professional		$156.96	$156.96	$156.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.64 / $794.43 / $3,177.13	Facility		$104.64	$794.43	$3,177.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $368.86 / $608.23 / $936.26	Professional		$368.86	$608.23	$936.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.49 / $58.40 / $612.96	Professional		$1.49	$58.40	$612.96
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $104.64 / $376.02 / $1,191.65	Facility		$104.64	$376.02	$1,191.65
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $156.96 / $156.96 / $156.96	Professional		$156.96	$156.96	$156.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $250.05 / $324.67	Professional		$130.08	$250.05	$324.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $1,270.13 / $3,177.13	Facility		$80.00	$1,270.13	$3,177.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.13 / $251.69 / $251.69	Professional		$88.13	$251.69	$251.69
United Facility/Professional Professional Modifier Low / Median / High Price $352.54 / $555.65 / $936.26	Professional		$352.54	$555.65	$936.26