Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $450.38 / $450.38 / $450.38	Facility		$450.38	$450.38	$450.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.94 / $413.53 / $538.55	Professional		$286.94	$413.53	$538.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $670.50 / $1,220.31 / $1,220.31	Facility		$670.50	$1,220.31	$1,220.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $221.88 / $623.57 / $838.12	Professional		$221.88	$623.57	$838.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.27 / $51.44 / $153.03	Facility		$47.27	$51.44	$153.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $450.88 / $450.88 / $1,838.28	Facility		$450.88	$450.88	$1,838.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $383.25 / $798.75 / $998.44	Professional		$383.25	$798.75	$998.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.21 / $406.00 / $748.14	Facility		$57.21	$406.00	$748.14
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $85.81 / $85.81 / $85.81	Professional		$85.81	$85.81	$85.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.21 / $623.45 / $3,564.78	Facility		$57.21	$623.45	$3,564.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $273.05 / $382.27 / $819.15	Professional		$273.05	$382.27	$819.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.21 / $406.00 / $748.14	Facility		$57.21	$406.00	$748.14
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $85.81 / $85.81 / $85.81	Professional		$85.81	$85.81	$85.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.87 / $158.55 / $205.86	Professional		$74.87	$158.55	$205.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $76.00 / $923.82 / $3,564.78	Facility		$76.00	$923.82	$3,564.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $53.68 / $450.88 / $450.88	Professional		$53.68	$450.88	$450.88
United Facility/Professional Facility Modifier Low / Median / High Price $28.17 / $229.57 / $469.44	Facility		$28.17	$229.57	$469.44
United Facility/Professional Professional Modifier Low / Median / High Price $252.96 / $360.23 / $808.22	Professional		$252.96	$360.23	$808.22