Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $554.40 / $676.80 / $676.80	Professional		$554.40	$676.80	$676.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.90 / $228.90 / $2,937.06	Professional		$228.90	$228.90	$2,937.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $720.00 / $720.00 / $1,095.61	Facility		$720.00	$720.00	$1,095.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,981.56 / $2,315.61 / $3,552.21	Facility		$1,981.56	$2,315.61	$3,552.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $827.24 / $1,938.82 / $2,203.19	Professional		$827.24	$1,938.82	$2,203.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $432.00 / $648.00 / $921.60	Facility		$432.00	$648.00	$921.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $432.00 / $720.00 / $3,420.00	Facility		$432.00	$720.00	$3,420.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $417.60 / $720.00 / $1,512.00	Professional		$417.60	$720.00	$1,512.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $360.00	Professional		$85.00	$85.00	$360.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $432.00 / $648.00 / $921.60	Facility		$432.00	$648.00	$921.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $845.88 / $1,716.91 / $2,448.60	Professional		$845.88	$1,716.91	$2,448.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,440.00 / $1,440.00 / $3,420.00	Facility		$1,440.00	$1,440.00	$3,420.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $381.60 / $381.60 / $381.60	Professional		$381.60	$381.60	$381.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,533.27 / $1,533.27 / $1,533.27	Professional		$1,533.27	$1,533.27	$1,533.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,931.20 / $3,931.20 / $3,931.20	Professional		$3,931.20	$3,931.20	$3,931.20
United Facility/Professional Professional Modifier Low / Median / High Price $388.80 / $432.00 / $1,512.00	Professional		$388.80	$432.00	$1,512.00