Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $364.80 / $364.80 / $364.80	Professional		$364.80	$364.80	$364.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $33.47 / $888.96	Professional		$33.47	$33.47	$888.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $584.23 / $584.23 / $584.23	Facility		$584.23	$584.23	$584.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,057.01 / $1,235.20 / $1,894.83	Facility		$1,057.01	$1,235.20	$1,894.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $454.32 / $1,034.03 / $1,175.04	Professional		$454.32	$1,034.03	$1,175.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $295.68 / $460.80 / $1,344.00	Facility		$295.68	$460.80	$1,344.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $295.68 / $460.80 / $1,344.00	Facility		$295.68	$460.80	$1,344.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $123.40 / $691.20	Professional		$96.00	$123.40	$691.20
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 $295.68 / $460.80 / $1,344.00	Facility		$295.68	$460.80	$1,344.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $640.98 / $915.53 / $1,284.09	Professional		$640.98	$915.53	$1,284.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $768.00 / $1,824.00 / $1,824.00	Facility		$768.00	$1,824.00	$1,824.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,536.00 / $1,536.00 / $1,912.32	Professional		$1,536.00	$1,536.00	$1,912.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $408.87 / $408.87 / $408.87	Professional		$408.87	$408.87	$408.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,096.64 / $2,096.64 / $2,096.64	Professional		$2,096.64	$2,096.64	$2,096.64
United Facility/Professional Facility Modifier Low / Median / High Price $384.00 / $384.00 / $384.00	Facility		$384.00	$384.00	$384.00
United Facility/Professional Professional Modifier Low / Median / High Price $103.33 / $153.60 / $509.20	Professional		$103.33	$153.60	$509.20