Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $554.40 / $576.00 / $676.80	Professional		$554.40	$576.00	$676.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,548.00 / $1,872.00 / $1,980.00	Facility		$1,548.00	$1,872.00	$1,980.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.90 / $228.90 / $2,937.06	Professional		$228.90	$228.90	$2,937.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,095.61 / $1,095.61 / $1,095.61	Facility		$1,095.61	$1,095.61	$1,095.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,981.56 / $2,315.61 / $3,552.21	Facility		$1,981.56	$2,315.61	$3,552.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $852.06 / $1,938.82 / $2,203.19	Professional		$852.06	$1,938.82	$2,203.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $554.40 / $864.00 / $2,520.00	Facility		$554.40	$864.00	$2,520.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $554.40 / $864.00 / $2,520.00	Facility		$554.40	$864.00	$2,520.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $360.00 / $432.00 / $2,220.37	Professional		$360.00	$432.00	$2,220.37
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 $554.40 / $864.00 / $2,520.00	Facility		$554.40	$864.00	$2,520.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,202.04 / $1,716.91 / $2,408.09	Professional		$1,202.04	$1,716.91	$2,408.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,440.00 / $3,420.00 / $3,420.00	Facility		$1,440.00	$3,420.00	$3,420.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,880.00 / $3,600.00 / $3,600.00	Professional		$2,880.00	$3,600.00	$3,600.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,533.27 / $1,533.27 / $1,533.27	Professional		$1,533.27	$1,533.27	$1,533.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,092.46 / $3,931.20 / $3,931.20	Professional		$2,092.46	$3,931.20	$3,931.20
United Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $432.00 / $1,909.50	Professional		$302.39	$432.00	$1,909.50