Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $717.49 / $717.49 / $1,333.34	Facility		$717.49	$717.49	$1,333.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $460.39 / $562.04 / $717.49	Professional		$460.39	$562.04	$717.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,285.51 / $1,554.57 / $1,644.25	Facility		$1,285.51	$1,554.57	$1,644.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.16 / $508.22 / $2,473.86	Professional		$239.16	$508.22	$2,473.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $909.58 / $1,461.24 / $1,461.24	Facility		$909.58	$1,461.24	$1,461.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,645.45 / $1,922.83 / $2,949.67	Facility		$1,645.45	$1,922.83	$2,949.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.42 / $1,610.05 / $1,829.60	Professional		$707.42	$1,610.05	$1,829.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $460.39 / $717.49 / $2,092.69	Facility		$460.39	$717.49	$2,092.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $538.12 / $717.49 / $2,092.69	Facility		$538.12	$717.49	$2,092.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $298.95 / $358.75 / $1,843.86	Professional		$298.95	$358.75	$1,843.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,650.23	Professional		$50.00	$70.00	$1,650.23
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $460.39 / $717.49 / $2,092.69	Facility		$460.39	$717.49	$2,092.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $997.92 / $1,425.36 / $1,999.17	Professional		$997.92	$1,425.36	$1,999.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,195.82 / $2,840.07 / $2,840.07	Facility		$1,195.82	$2,840.07	$2,840.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,391.64 / $2,989.55 / $2,989.55	Professional		$2,391.64	$2,989.55	$2,989.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,273.28 / $1,273.28 / $1,273.28	Professional		$1,273.28	$1,273.28	$1,273.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,737.65 / $3,264.59 / $3,264.59	Professional		$1,737.65	$3,264.59	$3,264.59
United Facility/Professional Facility Modifier Low / Median / High Price $717.49 / $717.49 / $717.49	Facility		$717.49	$717.49	$717.49
United Facility/Professional Professional Modifier Low / Median / High Price $269.06 / $358.75 / $1,112.95	Professional		$269.06	$358.75	$1,112.95