Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $888.58 / $888.58 / $888.58	Facility		$888.58	$888.58	$888.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $558.42 / $799.72 / $1,048.23	Professional		$558.42	$799.72	$1,048.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,321.30 / $2,404.77 / $2,404.77	Facility		$1,321.30	$2,404.77	$2,404.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,037.47 / $1,228.81 / $1,651.62	Professional		$1,037.47	$1,228.81	$1,651.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.15 / $101.36 / $301.50	Facility		$93.15	$101.36	$301.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $867.37 / $867.37 / $3,532.39	Facility		$867.37	$867.37	$3,532.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $737.26 / $1,530.00 / $1,912.50	Professional		$737.26	$1,530.00	$1,912.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $447.62 / $1,053.22 / $1,585.56	Facility		$447.62	$1,053.22	$1,585.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $936.19 / $936.19 / $1,585.56	Professional		$936.19	$936.19	$1,585.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $795.76 / $1,332.87 / $7,230.47	Facility		$795.76	$1,332.87	$7,230.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $587.64 / $801.32 / $1,650.60	Professional		$587.64	$801.32	$1,650.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $1,429.20	Professional		$50.00	$65.00	$1,429.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $447.62 / $1,193.64 / $1,585.56	Facility		$447.62	$1,193.64	$1,585.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $936.19 / $936.19 / $1,585.56	Professional		$936.19	$936.19	$1,585.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.53 / $321.83 / $417.87	Professional		$147.53	$321.83	$417.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $867.37 / $1,873.14 / $7,230.47	Facility		$867.37	$1,873.14	$7,230.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $103.85 / $867.37 / $867.37	Professional		$103.85	$867.37	$867.37
United Facility/Professional Professional Modifier Low / Median / High Price $513.16 / $801.32 / $1,689.83	Professional		$513.16	$801.32	$1,689.83