Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $942.76 / $942.76 / $942.76	Facility		$942.76	$942.76	$942.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $613.08 / $703.27 / $1,173.59	Professional		$613.08	$703.27	$1,173.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,065.59 / $1,939.39 / $1,939.39	Facility		$1,065.59	$1,939.39	$1,939.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $854.61 / $991.01 / $1,486.51	Professional		$854.61	$991.01	$1,486.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.13 / $75.13 / $228.04	Facility		$75.13	$75.13	$228.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $816.59 / $816.59 / $2,658.30	Facility		$816.59	$816.59	$2,658.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $694.10 / $1,151.25 / $1,439.06	Professional		$694.10	$1,151.25	$1,439.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $121.38 / $937.92 / $1,414.14	Facility		$121.38	$937.92	$1,414.14
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $127.87 / $127.87 / $790.70	Professional		$127.87	$127.87	$790.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $121.38 / $1,126.99 / $4,925.89	Facility		$121.38	$1,126.99	$4,925.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $480.24 / $648.47 / $1,159.74	Professional		$480.24	$648.47	$1,159.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.65 / $55.00 / $676.99	Professional		$1.65	$55.00	$676.99
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $121.38 / $937.92 / $1,414.14	Facility		$121.38	$937.92	$1,414.14
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $127.87 / $127.87 / $790.70	Professional		$127.87	$127.87	$790.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $118.98 / $219.29 / $284.73	Professional		$118.98	$219.29	$284.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $816.59 / $2,511.56 / $4,925.89	Facility		$816.59	$2,511.56	$4,925.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $92.43 / $816.59 / $816.59	Professional		$92.43	$816.59	$816.59
United Facility/Professional Professional Modifier Low / Median / High Price $448.94 / $629.65 / $1,159.74	Professional		$448.94	$629.65	$1,159.74