Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.89 / $39.89 / $88.95	Facility		$39.89	$39.89	$88.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.89 / $39.89 / $49.86	Professional		$39.89	$39.89	$49.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $859.20 / $1,511.79 / $3,281.49	Professional		$859.20	$1,511.79	$3,281.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.63 / $105.43 / $149.43	Facility		$57.63	$105.43	$149.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.19 / $1,562.68 / $1,775.78	Professional		$45.19	$1,562.68	$1,775.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.89 / $1,044.56 / $2,004.49	Facility		$39.89	$1,044.56	$2,004.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $28.33 / $28.33 / $28.33	Professional		$28.33	$28.33	$28.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.89 / $1,044.56 / $2,004.49	Facility		$39.89	$1,044.56	$2,004.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $42.28 / $54.96	Professional		$42.28	$42.28	$54.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $3,334.16	Professional		$55.00	$65.00	$3,334.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.89 / $1,044.56 / $2,004.49	Facility		$39.89	$1,044.56	$2,004.49
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $28.33 / $28.33 / $28.33	Professional		$28.33	$28.33	$28.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,518.48 / $2,168.90 / $3,042.02	Professional		$1,518.48	$2,168.90	$3,042.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,977.24 / $4,977.24 / $4,977.24	Facility		$4,977.24	$4,977.24	$4,977.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,700.68 / $2,151.87 / $3,109.44	Professional		$1,700.68	$2,151.87	$3,109.44
United Facility/Professional Professional Modifier Low / Median / High Price $42.28 / $42.28 / $57.89	Professional		$42.28	$42.28	$57.89