Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $910.86 / $910.86 / $910.86	Facility		$910.86	$910.86	$910.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $584.47 / $713.51 / $910.86	Professional		$584.47	$713.51	$910.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $500.00 / $500.00 / $3,140.58	Professional		$500.00	$500.00	$3,140.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,155.18 / $1,155.18 / $1,155.18	Facility		$1,155.18	$1,155.18	$1,155.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,088.80 / $2,440.92 / $3,744.44	Facility		$2,088.80	$2,440.92	$3,744.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $898.42 / $2,043.97 / $2,322.69	Professional		$898.42	$2,043.97	$2,322.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $584.47 / $910.86 / $2,656.68	Facility		$584.47	$910.86	$2,656.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $584.47 / $910.86 / $2,656.68	Facility		$584.47	$910.86	$2,656.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $379.53 / $455.43 / $2,340.80	Professional		$379.53	$455.43	$2,340.80
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 $584.47 / $910.86 / $2,656.68	Facility		$584.47	$910.86	$2,656.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,267.38 / $1,810.24 / $2,538.98	Professional		$1,267.38	$1,810.24	$2,538.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,518.10 / $3,605.49 / $3,605.49	Facility		$1,518.10	$3,605.49	$3,605.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,036.20 / $3,036.20 / $3,780.07	Professional		$3,036.20	$3,036.20	$3,780.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,616.78 / $1,616.78 / $1,616.78	Professional		$1,616.78	$1,616.78	$1,616.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,144.41 / $4,144.41 / $4,144.41	Professional		$4,144.41	$4,144.41	$4,144.41
United Facility/Professional Professional Modifier Low / Median / High Price $379.53 / $486.02 / $1,412.90	Professional		$379.53	$486.02	$1,412.90