Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $681.50 / $681.50 / $681.50	Professional		$681.50	$681.50	$681.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.08 / $255.08 / $2,999.70	Professional		$255.08	$255.08	$2,999.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,103.01 / $1,103.01 / $1,103.01	Facility		$1,103.01	$1,103.01	$1,103.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.08 / $2,331.41 / $3,576.44	Facility		$1,995.08	$2,331.41	$3,576.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $858.01 / $1,952.28 / $2,218.50	Professional		$858.01	$1,952.28	$2,218.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $558.25 / $870.00 / $2,537.50	Facility		$558.25	$870.00	$2,537.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $558.25 / $870.00 / $2,537.50	Facility		$558.25	$870.00	$2,537.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $362.50 / $435.00 / $2,235.79	Professional		$362.50	$435.00	$2,235.79
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 $558.25 / $870.00 / $2,537.50	Facility		$558.25	$870.00	$2,537.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,210.14 / $1,728.48 / $2,424.31	Professional		$1,210.14	$1,728.48	$2,424.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,450.00 / $3,443.75 / $3,443.75	Facility		$1,450.00	$3,443.75	$3,443.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,900.00 / $2,900.00 / $3,610.50	Professional		$2,900.00	$2,900.00	$3,610.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,543.92 / $1,543.92 / $1,543.92	Professional		$1,543.92	$1,543.92	$1,543.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,958.50 / $3,958.50 / $3,958.50	Professional		$3,958.50	$3,958.50	$3,958.50
United Facility/Professional Facility Modifier Low / Median / High Price $725.00 / $725.00 / $725.00	Facility		$725.00	$725.00	$725.00
United Facility/Professional Professional Modifier Low / Median / High Price $315.16 / $435.00 / $1,349.52	Professional		$315.16	$435.00	$1,349.52