Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $387.55 / $387.55 / $387.55	Facility		$387.55	$387.55	$387.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.68 / $303.58 / $387.55	Professional		$248.68	$303.58	$387.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $694.36 / $839.70 / $888.14	Facility		$694.36	$839.70	$888.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.95 / $5.95 / $1,317.44	Professional		$5.95	$5.95	$1,317.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $491.21 / $877.00 / $877.00	Facility		$491.21	$877.00	$877.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $888.50 / $1,038.29 / $1,592.76	Facility		$888.50	$1,038.29	$1,592.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.00 / $869.67 / $988.26	Professional		$382.00	$869.67	$988.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $248.68 / $387.55 / $1,130.35	Facility		$248.68	$387.55	$1,130.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $290.66 / $387.55 / $1,130.35	Facility		$290.66	$387.55	$1,130.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $179.43 / $215.31 / $1,106.64	Professional		$179.43	$215.31	$1,106.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $248.68 / $387.55 / $1,130.35	Facility		$248.68	$387.55	$1,130.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $538.91 / $769.76 / $1,079.64	Professional		$538.91	$769.76	$1,079.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $645.91 / $1,534.06 / $1,534.06	Facility		$645.91	$1,534.06	$1,534.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,291.83 / $1,614.80 / $1,614.80	Professional		$1,291.83	$1,614.80	$1,614.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $687.76 / $687.76 / $687.76	Professional		$687.76	$687.76	$687.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,763.36 / $1,763.36 / $1,763.36	Professional		$1,763.36	$1,763.36	$1,763.36
United Facility/Professional Facility Modifier Low / Median / High Price $322.95 / $322.95 / $322.95	Facility		$322.95	$322.95	$322.95
United Facility/Professional Professional Modifier Low / Median / High Price $150.72 / $215.31 / $753.59	Professional		$150.72	$215.31	$753.59