Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $433.64 / $433.64 / $433.64	Facility		$433.64	$433.64	$433.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.26 / $343.30 / $433.64	Professional		$278.26	$343.30	$433.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.82 / $205.82 / $1,474.11	Professional		$205.82	$205.82	$1,474.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $549.77 / $549.77 / $549.77	Facility		$549.77	$549.77	$549.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $994.84 / $1,162.55 / $1,783.37	Facility		$994.84	$1,162.55	$1,783.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $427.52 / $973.09 / $1,105.79	Professional		$427.52	$973.09	$1,105.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $278.26 / $433.64 / $1,264.80	Facility		$278.26	$433.64	$1,264.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $278.26 / $433.64 / $1,264.80	Facility		$278.26	$433.64	$1,264.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $180.69 / $216.82 / $1,114.41	Professional		$180.69	$216.82	$1,114.41
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 $278.26 / $433.64 / $1,264.80	Facility		$278.26	$433.64	$1,264.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $603.17 / $861.54 / $1,208.36	Professional		$603.17	$861.54	$1,208.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $722.74 / $1,716.51 / $1,716.51	Facility		$722.74	$1,716.51	$1,716.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,445.48 / $1,445.48 / $1,799.62	Professional		$1,445.48	$1,445.48	$1,799.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $769.72 / $769.72 / $769.72	Professional		$769.72	$769.72	$769.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,973.08 / $1,973.08 / $1,973.08	Professional		$1,973.08	$1,973.08	$1,973.08
United Facility/Professional Facility Modifier Low / Median / High Price $361.37 / $361.37 / $361.37	Facility		$361.37	$361.37	$361.37
United Facility/Professional Professional Modifier Low / Median / High Price $162.62 / $216.82 / $758.88	Professional		$162.62	$216.82	$758.88