Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $450.00 / $836.25	Facility		$450.00	$450.00	$836.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.00 / $450.00 / $450.00	Professional		$300.00	$450.00	$450.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $194.67 / $1,529.72	Professional		$150.00	$194.67	$1,529.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $570.46 / $916.46 / $916.46	Facility		$570.46	$916.46	$916.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,031.78 / $1,205.72 / $1,849.60	Facility		$1,031.78	$1,205.72	$1,849.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $402.86 / $1,009.80 / $1,147.50	Professional		$402.86	$1,009.80	$1,147.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $288.75 / $450.00 / $1,312.50	Facility		$288.75	$450.00	$1,312.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $288.75 / $480.00 / $1,312.50	Facility		$288.75	$480.00	$1,312.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.50 / $225.00 / $1,350.00	Professional		$187.50	$225.00	$1,350.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $288.75 / $450.00 / $1,312.50	Facility		$288.75	$450.00	$1,312.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $625.86 / $893.94 / $1,253.81	Professional		$625.86	$893.94	$1,253.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $1,781.25 / $1,781.25	Facility		$750.00	$1,781.25	$1,781.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $1,875.00 / $1,875.00	Professional		$1,500.00	$1,875.00	$1,875.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $798.58 / $798.58 / $798.58	Professional		$798.58	$798.58	$798.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,089.83 / $2,047.50 / $2,047.50	Professional		$1,089.83	$2,047.50	$2,047.50
United Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $375.00 / $375.00	Facility		$375.00	$375.00	$375.00
United Facility/Professional Professional Modifier Low / Median / High Price $168.75 / $225.00 / $698.03	Professional		$168.75	$225.00	$698.03