Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $313.32 / $313.32 / $313.32	Facility		$313.32	$313.32	$313.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.13 / $283.97 / $358.08	Professional		$210.13	$283.97	$358.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $450.60 / $450.60 / $820.09	Facility		$450.60	$450.60	$820.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $300.39 / $419.06 / $513.67	Professional		$300.39	$419.06	$513.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $58.58 / $96.43	Facility		$38.90	$58.58	$96.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.68 / $55.22 / $74.20	Professional		$46.68	$55.22	$74.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $318.39 / $1,464.32 / $2,001.38	Facility		$318.39	$1,464.32	$2,001.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.64 / $327.95 / $698.44	Professional		$270.64	$327.95	$698.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $58.02 / $210.13 / $455.90	Facility		$58.02	$210.13	$455.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $41.30 / $41.30 / $105.38	Professional		$41.30	$41.30	$105.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.76 / $87.82 / $370.57	Facility		$60.76	$87.82	$370.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.17 / $30.98 / $66.26	Professional		$23.17	$30.98	$66.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $56.79 / $210.13 / $455.90	Facility		$56.79	$210.13	$455.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $41.30 / $41.30 / $105.38	Professional		$41.30	$41.30	$105.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.31 / $104.12 / $142.80	Professional		$50.31	$104.12	$142.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $318.39	Facility		$65.00	$65.00	$318.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $270.64 / $318.39 / $318.39	Professional		$270.64	$318.39	$318.39
United Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $30.90 / $63.35	Professional		$17.50	$30.90	$63.35