Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $953.39 / $953.39 / $953.39	Facility		$953.39	$953.39	$953.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $611.76 / $746.82 / $953.39	Professional		$611.76	$746.82	$953.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.16 / $239.16 / $3,240.91	Professional		$239.16	$239.16	$3,240.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,208.83 / $1,208.83 / $1,208.83	Facility		$1,208.83	$1,208.83	$1,208.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,186.12 / $2,554.65 / $3,918.90	Facility		$2,186.12	$2,554.65	$3,918.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $940.11 / $2,139.40 / $2,431.14	Professional		$940.11	$2,139.40	$2,431.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $611.76 / $953.39 / $2,780.72	Facility		$611.76	$953.39	$2,780.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $611.76 / $953.39 / $2,780.72	Facility		$611.76	$953.39	$2,780.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $397.25 / $476.69 / $2,450.09	Professional		$397.25	$476.69	$2,450.09
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 $611.76 / $953.39 / $2,780.72	Facility		$611.76	$953.39	$2,780.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,326.24 / $1,894.31 / $2,656.90	Professional		$1,326.24	$1,894.31	$2,656.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,588.98 / $3,773.83 / $3,773.83	Facility		$1,588.98	$3,773.83	$3,773.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,177.96 / $3,177.96 / $3,956.56	Professional		$3,177.96	$3,177.96	$3,956.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,692.26 / $1,692.26 / $1,692.26	Professional		$1,692.26	$1,692.26	$1,692.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,337.92 / $4,337.92 / $4,337.92	Professional		$4,337.92	$4,337.92	$4,337.92
United Facility/Professional Facility Modifier Low / Median / High Price $794.49 / $794.49 / $794.49	Facility		$794.49	$794.49	$794.49
United Facility/Professional Professional Modifier Low / Median / High Price $357.52 / $476.69 / $1,478.86	Professional		$357.52	$476.69	$1,478.86