Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $541.09 / $541.09 / $541.09	Facility		$541.09	$541.09	$541.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.20 / $423.86 / $541.09	Professional		$347.20	$423.86	$541.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $969.46 / $1,172.36 / $1,240.00	Facility		$969.46	$1,172.36	$1,240.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.36 / $180.36 / $1,931.34	Professional		$180.36	$180.36	$1,931.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $686.12 / $686.12 / $686.12	Facility		$686.12	$686.12	$686.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,240.83 / $1,450.02 / $2,224.37	Facility		$1,240.83	$1,450.02	$2,224.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $533.86 / $1,214.21 / $1,379.79	Professional		$533.86	$1,214.21	$1,379.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $347.20 / $541.09 / $1,578.19	Facility		$347.20	$541.09	$1,578.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $347.20 / $541.09 / $1,578.19	Facility		$347.20	$541.09	$1,578.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $225.46 / $270.55 / $1,390.54	Professional		$225.46	$270.55	$1,390.54
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 $347.20 / $541.09 / $1,578.19	Facility		$347.20	$541.09	$1,578.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $752.76 / $1,075.19 / $1,508.03	Professional		$752.76	$1,075.19	$1,508.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $901.82 / $2,141.82 / $2,141.82	Facility		$901.82	$2,141.82	$2,141.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,803.64 / $2,254.55 / $2,254.55	Professional		$1,803.64	$2,254.55	$2,254.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $960.23 / $960.23 / $960.23	Professional		$960.23	$960.23	$960.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,310.44 / $2,461.96 / $2,461.96	Professional		$1,310.44	$2,461.96	$2,461.96
United Facility/Professional Professional Modifier Low / Median / High Price $225.46 / $270.55 / $946.91	Professional		$225.46	$270.55	$946.91