Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $416.78 / $416.78	Facility		$416.78	$416.78	$416.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $416.78	Professional		$416.78	$416.78	$416.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.71 / $354.26 / $1,700.15	Professional		$166.71	$354.26	$1,700.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $633.95 / $633.95 / $633.95	Facility		$633.95	$633.95	$633.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $909.41 / $1,196.11 / $1,630.24	Facility		$909.41	$1,196.11	$1,630.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $493.32 / $1,122.31 / $1,275.34	Professional		$493.32	$1,122.31	$1,275.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $458.46 / $1,458.73	Facility		$416.78	$458.46	$1,458.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $500.14 / $1,458.73	Facility		$416.78	$500.14	$1,458.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $191.83 / $250.10 / $1,227.13	Professional		$191.83	$250.10	$1,227.13
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 $416.78 / $458.46 / $1,458.73	Facility		$416.78	$458.46	$1,458.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $695.52 / $993.43 / $1,393.36	Professional		$695.52	$993.43	$1,393.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $833.56 / $1,979.71 / $1,979.71	Facility		$833.56	$1,979.71	$1,979.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,667.12 / $1,667.12 / $2,075.56	Professional		$1,667.12	$1,667.12	$2,075.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $500.14	Professional		$416.78	$416.78	$500.14
Security Health Facility/Professional Facility Modifier Low / Median / High Price $500.14 / $500.14 / $500.14	Facility		$500.14	$500.14	$500.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $2,188.10	Professional		$416.78	$416.78	$2,188.10
United Facility/Professional Professional Modifier Low / Median / High Price $191.83 / $267.52 / $845.67	Professional		$191.83	$267.52	$845.67