Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.00 / $240.00 / $535.20	Facility		$240.00	$240.00	$535.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $240.00 / $300.00	Professional		$240.00	$240.00	$300.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $402.01 / $467.20 / $484.58	Facility		$402.01	$467.20	$484.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.18 / $217.30 / $250.50	Professional		$65.18	$217.30	$250.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $255.00 / $438.80 / $761.21	Facility		$255.00	$438.80	$761.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $121.25 / $279.38	Professional		$106.70	$121.25	$279.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.59 / $217.30 / $300.00	Facility		$63.59	$217.30	$300.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $33.94 / $255.00 / $325.95	Professional		$33.94	$255.00	$325.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.59 / $255.00 / $1,139.65	Facility		$63.59	$255.00	$1,139.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.50 / $250.00 / $325.00	Professional		$187.50	$250.00	$325.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $876.75	Professional		$55.00	$85.00	$876.75
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $63.59 / $217.30 / $300.00	Facility		$63.59	$217.30	$300.00
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $33.94 / $255.00 / $325.95	Professional		$33.94	$255.00	$325.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.04 / $146.44 / $218.04	Professional		$71.04	$146.44	$218.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $899.88 / $1,139.65	Facility		$300.00	$899.88	$1,139.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $255.00 / $255.00	Professional		$255.00	$255.00	$255.00
Security Health Facility/Professional Facility Modifier Low / Median / High Price $136.44 / $136.44 / $212.05	Facility		$136.44	$136.44	$212.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $115.97 / $133.71 / $212.05	Professional		$115.97	$133.71	$212.05
United Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $250.00 / $325.00	Professional		$250.00	$250.00	$325.00