Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $649.19 / $649.19 / $649.19	Facility		$649.19	$649.19	$649.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $443.61 / $508.53 / $649.19	Professional		$443.61	$508.53	$649.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $2,163.96	Professional		$50.00	$50.00	$2,163.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $372.20 / $540.99 / $822.95	Facility		$372.20	$540.99	$822.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,488.65 / $1,739.61 / $2,668.60	Facility		$1,488.65	$1,739.61	$2,668.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $621.57 / $1,456.77 / $1,655.43	Professional		$621.57	$1,456.77	$1,655.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $270.50 / $486.89 / $692.47	Facility		$270.50	$486.89	$692.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $270.50 / $540.99 / $2,569.69	Facility		$270.50	$540.99	$2,569.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $313.77 / $540.99 / $1,136.08	Professional		$313.77	$540.99	$1,136.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $85.00	Professional		$55.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $270.50 / $486.89 / $692.47	Facility		$270.50	$486.89	$692.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $635.36 / $1,289.60 / $1,839.20	Professional		$635.36	$1,289.60	$1,839.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,081.98 / $1,081.98 / $2,569.69	Facility		$1,081.98	$1,081.98	$2,569.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $286.72 / $286.72 / $286.72	Professional		$286.72	$286.72	$286.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,152.06 / $1,152.06 / $1,152.06	Professional		$1,152.06	$1,152.06	$1,152.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,840.20 / $2,953.81 / $2,953.81	Professional		$2,840.20	$2,953.81	$2,953.81
United Facility/Professional Professional Modifier Low / Median / High Price $270.50 / $432.79 / $1,434.75	Professional		$270.50	$432.79	$1,434.75