Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $576.03 / $576.03 / $576.03	Facility		$576.03	$576.03	$576.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $362.59 / $513.58 / $680.49	Professional		$362.59	$513.58	$680.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $816.90 / $1,486.76 / $1,486.76	Facility		$816.90	$1,486.76	$1,486.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $716.46 / $759.72 / $1,021.12	Professional		$716.46	$759.72	$1,021.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.59 / $74.18 / $220.68	Facility		$57.59	$74.18	$220.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.96 / $407.96 / $2,153.67	Facility		$407.96	$407.96	$2,153.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.77 / $933.75 / $1,167.19	Professional		$346.77	$933.75	$1,167.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $118.59 / $582.46 / $961.06	Facility		$118.59	$582.46	$961.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $123.74 / $123.74 / $685.25	Professional		$123.74	$123.74	$685.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $105.14 / $864.05 / $2,957.66	Facility		$105.14	$864.05	$2,957.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $343.38 / $556.45 / $856.56	Professional		$343.38	$556.45	$856.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $321.16 / $585.23	Professional		$55.00	$321.16	$585.23
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $118.59 / $576.03 / $961.06	Facility		$118.59	$576.03	$961.06
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $123.74 / $123.74 / $685.25	Professional		$123.74	$123.74	$685.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.21 / $180.64 / $234.54	Professional		$91.21	$180.64	$234.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $407.96 / $1,064.64 / $2,957.66	Facility		$407.96	$1,064.64	$2,957.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.33 / $407.96 / $407.96	Professional		$64.33	$407.96	$407.96
United Facility/Professional Professional Modifier Low / Median / High Price $310.36 / $457.84 / $856.56	Professional		$310.36	$457.84	$856.56