Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.78 / $794.78 / $794.78	Facility		$794.78	$794.78	$794.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $509.99 / $629.20 / $794.78	Professional		$509.99	$629.20	$794.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $662.32 / $1,986.96 / $3,542.85	Professional		$662.32	$1,986.96	$3,542.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,008.01 / $1,008.01 / $1,008.01	Facility		$1,008.01	$1,008.01	$1,008.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,822.97 / $2,130.28 / $3,267.90	Facility		$1,822.97	$2,130.28	$3,267.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $783.99 / $1,783.50 / $2,026.70	Professional		$783.99	$1,783.50	$2,026.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $509.99 / $794.78 / $2,318.12	Facility		$509.99	$794.78	$2,318.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $509.99 / $794.78 / $2,318.12	Facility		$509.99	$794.78	$2,318.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $331.16 / $397.39 / $2,042.50	Professional		$331.16	$397.39	$2,042.50
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 $509.99 / $794.78 / $2,318.12	Facility		$509.99	$794.78	$2,318.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,105.92 / $1,579.62 / $2,215.53	Professional		$1,105.92	$1,579.62	$2,215.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,324.64 / $3,146.02 / $3,146.02	Facility		$1,324.64	$3,146.02	$3,146.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,649.28 / $2,649.28 / $3,298.35	Professional		$2,649.28	$2,649.28	$3,298.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,410.74 / $1,410.74 / $1,410.74	Professional		$1,410.74	$1,410.74	$1,410.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,616.27 / $3,616.27 / $3,616.27	Professional		$3,616.27	$3,616.27	$3,616.27
United Facility/Professional Professional Modifier Low / Median / High Price $298.04 / $397.39 / $1,232.83	Professional		$298.04	$397.39	$1,232.83