Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $701.88 / $701.88 / $701.88	Facility		$701.88	$701.88	$701.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $450.37 / $549.80 / $701.88	Professional		$450.37	$549.80	$701.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.83 / $288.83 / $2,420.03	Professional		$288.83	$288.83	$2,420.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $889.89 / $889.89 / $889.89	Facility		$889.89	$889.89	$889.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,609.40 / $1,880.71 / $2,885.06	Facility		$1,609.40	$1,880.71	$2,885.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $692.11 / $1,575.02 / $1,789.80	Professional		$692.11	$1,575.02	$1,789.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $450.37 / $701.88 / $2,047.15	Facility		$450.37	$701.88	$2,047.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $450.37 / $701.88 / $2,047.15	Facility		$450.37	$701.88	$2,047.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $292.45 / $350.94 / $1,803.74	Professional		$292.45	$350.94	$1,803.74
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 $450.37 / $701.88 / $2,047.15	Facility		$450.37	$701.88	$2,047.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $976.32 / $1,394.51 / $1,955.89	Professional		$976.32	$1,394.51	$1,955.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,169.80 / $2,778.28 / $2,778.28	Facility		$1,169.80	$2,778.28	$2,778.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,339.60 / $2,339.60 / $2,912.80	Professional		$2,339.60	$2,339.60	$2,912.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,245.57 / $1,245.57 / $1,245.57	Professional		$1,245.57	$1,245.57	$1,245.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,193.55 / $3,193.55 / $3,193.55	Professional		$3,193.55	$3,193.55	$3,193.55
United Facility/Professional Facility Modifier Low / Median / High Price $584.90 / $584.90 / $584.90	Facility		$584.90	$584.90	$584.90
United Facility/Professional Professional Modifier Low / Median / High Price $263.20 / $350.94 / $1,228.29	Professional		$263.20	$350.94	$1,228.29