Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $298.27 / $298.27 / $298.27	Facility		$298.27	$298.27	$298.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.37 / $239.70 / $352.80	Professional		$188.37	$239.70	$352.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $447.70 / $814.81 / $814.81	Facility		$447.70	$814.81	$814.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $329.40 / $416.36 / $559.62	Professional		$329.40	$416.36	$559.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.21 / $32.21 / $95.81	Facility		$32.21	$32.21	$95.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $209.52 / $209.52 / $1,207.50	Facility		$209.52	$209.52	$1,207.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.09 / $517.50 / $646.88	Professional		$178.09	$517.50	$646.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $217.78 / $298.27 / $536.89	Facility		$217.78	$298.27	$536.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $256.20 / $256.20 / $537.24	Professional		$256.20	$256.20	$537.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $217.78 / $447.70 / $2,008.95	Facility		$217.78	$447.70	$2,008.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $175.43 / $223.38 / $498.77	Professional		$175.43	$223.38	$498.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $447.70	Professional		$50.00	$90.00	$447.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $217.78 / $298.27 / $536.89	Facility		$217.78	$298.27	$536.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $256.20 / $256.20 / $537.24	Professional		$256.20	$256.20	$537.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.28 / $89.13 / $115.73	Professional		$50.28	$89.13	$115.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $209.52 / $723.14 / $2,008.95	Facility		$209.52	$723.14	$2,008.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $209.52 / $290.14	Professional		$31.65	$209.52	$290.14
United Facility/Professional Professional Modifier Low / Median / High Price $148.63 / $223.38 / $498.77	Professional		$148.63	$223.38	$498.77