Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $447.37 / $963.24 / $997.64	Facility		$447.37	$963.24	$997.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $447.37 / $447.37 / $1,200.06	Professional		$447.37	$447.37	$1,200.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $913.84 / $1,062.04 / $1,101.55	Facility		$913.84	$1,062.04	$1,101.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $469.37 / $783.85 / $1,126.26	Professional		$469.37	$783.85	$1,126.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $475.33 / $1,199.17 / $1,714.13	Facility		$475.33	$1,199.17	$1,714.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $475.33 / $677.86 / $770.30	Professional		$475.33	$677.86	$770.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $251.64 / $447.37 / $493.97	Facility		$251.64	$447.37	$493.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $89.78 / $89.78 / $740.96	Professional		$89.78	$89.78	$740.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $4.26 / $383.86 / $493.97	Facility		$4.26	$383.86	$493.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $466.01 / $466.01 / $638.05	Professional		$466.01	$466.01	$638.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.00 / $85.00	Professional		$65.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $251.64 / $447.37 / $493.97	Facility		$251.64	$447.37	$493.97
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $89.78 / $89.78 / $740.96	Professional		$89.78	$89.78	$740.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $190.62 / $279.58 / $400.87	Professional		$190.62	$279.58	$400.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $475.33 / $475.33 / $2,290.19	Facility		$475.33	$475.33	$2,290.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $475.33 / $475.33 / $475.33	Professional		$475.33	$475.33	$475.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $522.20 / $693.53 / $693.53	Professional		$522.20	$693.53	$693.53
United Facility/Professional Facility Modifier Low / Median / High Price $4.26 / $4.26 / $4.26	Facility		$4.26	$4.26	$4.26
United Facility/Professional Professional Modifier Low / Median / High Price $466.01 / $466.01 / $638.05	Professional		$466.01	$466.01	$638.05