Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $472.85 / $472.85 / $472.85	Facility		$472.85	$472.85	$472.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.08 / $421.09 / $566.91	Professional		$302.08	$421.09	$566.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $630.10 / $1,146.78 / $1,146.78	Facility		$630.10	$1,146.78	$1,146.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $585.99 / $602.13 / $790.04	Professional		$585.99	$602.13	$790.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.42 / $69.56 / $206.94	Facility		$44.42	$69.56	$206.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $459.79 / $459.79 / $1,658.06	Facility		$459.79	$459.79	$1,658.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $390.82 / $720.00 / $900.00	Professional		$390.82	$720.00	$900.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $111.21 / $545.92 / $722.56	Facility		$111.21	$545.92	$722.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $116.04 / $116.04 / $642.27	Professional		$116.04	$116.04	$642.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.70 / $805.87 / $3,203.72	Facility		$96.70	$805.87	$3,203.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $279.06 / $521.54 / $802.84	Professional		$279.06	$521.54	$802.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $289.02 / $526.66	Professional		$55.00	$289.02	$526.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $111.21 / $545.92 / $722.56	Facility		$111.21	$545.92	$722.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $116.04 / $116.04 / $642.27	Professional		$116.04	$116.04	$642.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.36 / $142.77 / $185.38	Professional		$70.36	$142.77	$185.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $459.79 / $1,153.20 / $3,203.72	Facility		$459.79	$1,153.20	$3,203.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.73 / $459.79 / $459.79	Professional		$50.73	$459.79	$459.79
United Facility/Professional Professional Modifier Low / Median / High Price $279.06 / $428.00 / $772.35	Professional		$279.06	$428.00	$772.35