Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $898.07 / $898.07 / $898.07	Facility		$898.07	$898.07	$898.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $898.07 / $898.07 / $898.07	Professional		$898.07	$898.07	$898.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $335.33 / $335.33 / $2,993.56	Professional		$335.33	$335.33	$2,993.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,138.93 / $1,138.93 / $1,138.93	Facility		$1,138.93	$1,138.93	$1,138.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,059.96 / $2,407.23 / $3,692.75	Facility		$2,059.96	$2,407.23	$3,692.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $886.09 / $2,015.27 / $2,290.08	Professional		$886.09	$2,015.27	$2,290.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $576.26 / $898.07 / $2,619.37	Facility		$576.26	$898.07	$2,619.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $576.26 / $898.07 / $2,619.37	Facility		$576.26	$898.07	$2,619.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $374.20 / $449.03 / $2,307.92	Professional		$374.20	$449.03	$2,307.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $576.26 / $898.07 / $2,619.37	Facility		$576.26	$898.07	$2,619.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,249.56 / $1,784.79 / $2,503.29	Professional		$1,249.56	$1,784.79	$2,503.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,496.78 / $3,554.85 / $3,554.85	Facility		$1,496.78	$3,554.85	$3,554.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,993.56 / $2,993.56 / $3,726.98	Professional		$2,993.56	$2,993.56	$3,726.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,593.73 / $1,593.73 / $1,593.73	Professional		$1,593.73	$1,593.73	$1,593.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,174.98 / $4,086.21 / $4,086.21	Professional		$2,174.98	$4,086.21	$4,086.21
United Facility/Professional Professional Modifier Low / Median / High Price $336.78 / $449.03 / $1,984.80	Professional		$336.78	$449.03	$1,984.80