Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $629.72 / $739.92 / $739.92	Professional		$629.72	$739.92	$739.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $540.00 / $540.00 / $3,371.52	Professional		$540.00	$540.00	$3,371.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,197.51 / $1,197.51 / $1,197.51	Facility		$1,197.51	$1,197.51	$1,197.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,166.29 / $2,531.48 / $3,883.36	Facility		$2,166.29	$2,531.48	$3,883.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $931.60 / $2,119.63 / $2,408.67	Professional		$931.60	$2,119.63	$2,408.67
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $606.11 / $944.58 / $2,755.03	Facility		$606.11	$944.58	$2,755.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $606.11 / $944.58 / $2,755.03	Facility		$606.11	$944.58	$2,755.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $393.58 / $472.29 / $2,427.44	Professional		$393.58	$472.29	$2,427.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $70.00	Professional		$50.00	$65.00	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $606.11 / $944.58 / $2,755.03	Facility		$606.11	$944.58	$2,755.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,313.82 / $1,876.57 / $2,632.02	Professional		$1,313.82	$1,876.57	$2,632.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,574.30 / $3,738.96 / $3,738.96	Facility		$1,574.30	$3,738.96	$3,738.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,148.60 / $3,148.60 / $3,920.01	Professional		$3,148.60	$3,148.60	$3,920.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,676.27 / $1,676.27 / $1,676.27	Professional		$1,676.27	$1,676.27	$1,676.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,297.84 / $4,297.84 / $4,297.84	Professional		$4,297.84	$4,297.84	$4,297.84
United Facility/Professional Professional Modifier Low / Median / High Price $342.17 / $472.29 / $1,653.02	Professional		$342.17	$472.29	$1,653.02