Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $543.80 / $663.88 / $847.50	Professional		$543.80	$663.88	$847.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.59 / $1,103.82 / $3,269.94	Professional		$60.59	$1,103.82	$3,269.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,074.46 / $1,074.46 / $1,074.46	Facility		$1,074.46	$1,074.46	$1,074.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,271.39 / $2,581.12 / $3,663.66	Facility		$2,271.39	$2,581.12	$3,663.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $847.50 / $1,030.66 / $2,161.13	Professional		$847.50	$1,030.66	$2,161.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $635.63 / $847.50 / $2,471.88	Facility		$635.63	$847.50	$2,471.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $635.63 / $991.58 / $2,471.88	Facility		$635.63	$991.58	$2,471.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $307.01 / $423.75 / $3,517.13	Professional		$307.01	$423.75	$3,517.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $353.13	Professional		$50.00	$70.00	$353.13
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $635.63 / $847.50 / $2,471.88	Facility		$635.63	$847.50	$2,471.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,178.82 / $1,666.28 / $2,361.57	Professional		$1,178.82	$1,666.28	$2,361.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,412.50 / $1,412.50 / $3,354.69	Facility		$1,412.50	$1,412.50	$3,354.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,825.00 / $2,825.00 / $3,517.13	Professional		$2,825.00	$2,825.00	$3,517.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,503.99 / $1,503.99 / $1,503.99	Professional		$1,503.99	$1,503.99	$1,503.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,707.81 / $3,856.13 / $3,856.13	Professional		$3,707.81	$3,856.13	$3,856.13
United Facility/Professional Professional Modifier Low / Median / High Price $317.81 / $423.75 / $1,314.61	Professional		$317.81	$423.75	$1,314.61