Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $402.78 / $402.78 / $402.78	Facility		$402.78	$402.78	$402.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $265.88 / $322.41 / $532.62	Professional		$265.88	$322.41	$532.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $486.80 / $885.98 / $885.98	Facility		$486.80	$885.98	$885.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $390.23 / $452.72 / $675.57	Professional		$390.23	$452.72	$675.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.32 / $34.32 / $104.18	Facility		$34.32	$34.32	$104.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $329.00 / $329.00 / $1,216.51	Facility		$329.00	$329.00	$1,216.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.64 / $528.75 / $660.94	Professional		$279.64	$528.75	$660.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $55.65 / $313.02 / $604.16	Facility		$55.65	$313.02	$604.16
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $58.42 / $58.42 / $362.35	Professional		$58.42	$58.42	$362.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.65 / $516.46 / $1,989.48	Facility		$55.65	$516.46	$1,989.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $198.30 / $288.73 / $484.46	Professional		$198.30	$288.73	$484.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $0.67 / $55.00 / $277.32	Professional		$0.67	$55.00	$277.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $55.65 / $402.78 / $604.16	Facility		$55.65	$402.78	$604.16
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $58.42 / $58.42 / $362.35	Professional		$58.42	$58.42	$362.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.35 / $88.35 / $114.71	Professional		$54.35	$88.35	$114.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $329.00 / $1,151.33 / $1,989.48	Facility		$329.00	$1,151.33	$1,989.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.42 / $329.00 / $329.00	Professional		$41.42	$329.00	$329.00
United Facility/Professional Professional Modifier Low / Median / High Price $198.30 / $264.39 / $494.20	Professional		$198.30	$264.39	$494.20