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 $264.83 / $303.58 / $387.55	Professional		$264.83	$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 / $6.83 / $1,291.83	Professional		$5.95	$6.83	$1,291.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $222.20 / $491.21 / $877.00	Facility		$222.20	$491.21	$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 $370.87 / $869.67 / $988.26	Professional		$370.87	$869.67	$988.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $171.17 / $290.66 / $591.02	Facility		$171.17	$290.66	$591.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $171.17 / $322.95 / $1,534.06	Facility		$171.17	$322.95	$1,534.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.32 / $322.95 / $753.59	Professional		$187.32	$322.95	$753.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.00 / $161.47	Professional		$55.00	$65.00	$161.47
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $171.17 / $290.66 / $591.02	Facility		$171.17	$290.66	$591.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $379.24 / $768.46 / $1,097.80	Professional		$379.24	$768.46	$1,097.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $645.91 / $645.91 / $1,534.06	Facility		$645.91	$645.91	$1,534.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $171.17 / $171.17 / $171.17	Professional		$171.17	$171.17	$171.17
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 $1,695.54 / $1,763.36 / $1,763.36	Professional		$1,695.54	$1,763.36	$1,763.36
United Facility/Professional Professional Modifier Low / Median / High Price $179.43 / $258.37 / $645.92	Professional		$179.43	$258.37	$645.92