Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $633.44 / $633.44 / $633.44	Facility		$633.44	$633.44	$633.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $406.46 / $496.20 / $633.44	Professional		$406.46	$496.20	$633.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.15 / $211.15 / $2,184.06	Professional		$211.15	$211.15	$2,184.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $803.27 / $803.27 / $803.27	Facility		$803.27	$803.27	$803.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,452.61 / $1,697.48 / $2,603.98	Facility		$1,452.61	$1,697.48	$2,603.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $624.90 / $1,421.45 / $1,615.29	Professional		$624.90	$1,421.45	$1,615.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $406.46 / $633.44 / $1,847.55	Facility		$406.46	$633.44	$1,847.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $406.46 / $633.44 / $1,847.55	Facility		$406.46	$633.44	$1,847.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $263.94 / $316.72 / $1,627.87	Professional		$263.94	$316.72	$1,627.87
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 $406.46 / $633.44 / $1,847.55	Facility		$406.46	$633.44	$1,847.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $881.28 / $1,258.76 / $1,765.50	Professional		$881.28	$1,258.76	$1,765.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,055.74 / $2,507.38 / $2,507.38	Facility		$1,055.74	$2,507.38	$2,507.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,111.48 / $2,111.48 / $2,628.79	Professional		$2,111.48	$2,111.48	$2,628.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,124.11 / $1,124.11 / $1,124.11	Professional		$1,124.11	$1,124.11	$1,124.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,882.17 / $2,882.17 / $2,882.17	Professional		$2,882.17	$2,882.17	$2,882.17
United Facility/Professional Professional Modifier Low / Median / High Price $229.47 / $316.72 / $982.58	Professional		$229.47	$316.72	$982.58