Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $374.71 / $374.71 / $374.71	Facility		$374.71	$374.71	$374.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.48 / $337.24 / $441.99	Professional		$235.48	$337.24	$441.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $560.40 / $1,019.93 / $1,019.93	Facility		$560.40	$1,019.93	$1,019.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $430.61 / $521.16 / $700.50	Professional		$430.61	$521.16	$700.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.50 / $42.05 / $125.10	Facility		$39.50	$42.05	$125.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $279.36 / $279.36 / $1,495.86	Facility		$279.36	$279.36	$1,495.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.46 / $648.75 / $810.94	Professional		$237.46	$648.75	$810.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $330.28 / $489.60 / $672.48	Facility		$330.28	$489.60	$672.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $388.57 / $388.57 / $672.48	Professional		$388.57	$388.57	$672.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $330.28 / $562.07 / $3,065.64	Facility		$330.28	$562.07	$3,065.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $243.90 / $336.91 / $696.00	Professional		$243.90	$336.91	$696.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $90.00 / $466.30	Professional		$50.00	$90.00	$466.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $330.28 / $489.60 / $672.48	Facility		$330.28	$489.60	$672.48
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $388.57 / $388.57 / $672.48	Professional		$388.57	$388.57	$672.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.56 / $136.46 / $177.19	Professional		$62.56	$136.46	$177.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $279.36 / $794.50 / $3,065.64	Facility		$279.36	$794.50	$3,065.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.04 / $279.36 / $382.62	Professional		$44.04	$279.36	$382.62
United Facility/Professional Professional Modifier Low / Median / High Price $232.00 / $324.80 / $696.00	Professional		$232.00	$324.80	$696.00