Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $661.50 / $661.50 / $661.50	Facility		$661.50	$661.50	$661.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $434.92 / $499.07 / $786.96	Professional		$434.92	$499.07	$786.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $749.00 / $1,363.18 / $1,363.18	Facility		$749.00	$1,363.18	$1,363.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $610.39 / $696.57 / $1,044.84	Professional		$610.39	$696.57	$1,044.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.81 / $52.81 / $160.29	Facility		$52.81	$52.81	$160.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $612.00 / $612.00 / $1,883.34	Facility		$612.00	$612.00	$1,883.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.00 / $817.50 / $1,021.88	Professional		$382.00	$817.50	$1,021.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $85.28 / $658.96 / $992.25	Facility		$85.28	$658.96	$992.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $89.88 / $89.88 / $555.54	Professional		$89.88	$89.88	$555.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.28 / $791.83 / $3,513.43	Facility		$85.28	$791.83	$3,513.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $321.24 / $455.76 / $815.98	Professional		$321.24	$455.76	$815.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.24 / $55.00 / $509.05	Professional		$1.24	$55.00	$509.05
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $85.28 / $658.96 / $992.25	Facility		$85.28	$658.96	$992.25
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $89.88 / $89.88 / $555.54	Professional		$89.88	$89.88	$555.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.63 / $156.97 / $203.82	Professional		$83.63	$156.97	$203.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $612.00 / $1,763.55 / $3,513.43	Facility		$612.00	$1,763.55	$3,513.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $612.00 / $612.00	Professional		$65.56	$612.00	$612.00
United Facility/Professional Professional Modifier Low / Median / High Price $315.52 / $420.70 / $787.24	Professional		$315.52	$420.70	$787.24