Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $491.88 / $491.88 / $491.88	Facility		$491.88	$491.88	$491.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.41 / $491.88 / $491.88	Professional		$389.41	$491.88	$491.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $881.29 / $1,065.74 / $1,127.23	Facility		$881.29	$1,065.74	$1,127.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.97 / $80.97 / $1,755.68	Professional		$80.97	$80.97	$1,755.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $623.61 / $1,113.08 / $1,113.08	Facility		$623.61	$1,113.08	$1,113.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,128.20 / $1,318.39 / $2,022.45	Facility		$1,128.20	$1,318.39	$2,022.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $484.94 / $1,103.78 / $1,254.30	Professional		$484.94	$1,103.78	$1,254.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $315.62 / $491.88 / $1,434.65	Facility		$315.62	$491.88	$1,434.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $368.91 / $491.88 / $1,434.65	Facility		$368.91	$491.88	$1,434.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $227.73 / $273.27 / $1,404.54	Professional		$227.73	$273.27	$1,404.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,131.32	Professional		$50.00	$70.00	$1,131.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $315.62 / $491.88 / $1,434.65	Facility		$315.62	$491.88	$1,434.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $684.18 / $977.24 / $1,370.64	Professional		$684.18	$977.24	$1,370.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $819.80 / $1,947.03 / $1,947.03	Facility		$819.80	$1,947.03	$1,947.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,639.60 / $2,049.50 / $2,049.50	Professional		$1,639.60	$2,049.50	$2,049.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $872.90 / $872.90 / $872.90	Professional		$872.90	$872.90	$872.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,191.26 / $2,238.05 / $2,238.05	Professional		$1,191.26	$2,238.05	$2,238.05
United Facility/Professional Professional Modifier Low / Median / High Price $191.29 / $273.27 / $807.00	Professional		$191.29	$273.27	$807.00