Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,100.00 / $1,213.00 / $1,213.00	Facility		$1,100.00	$1,213.00	$1,213.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $345.54 / $649.61 / $2,030.63	Professional		$345.54	$649.61	$2,030.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $306.20 / $321.52 / $428.69	Facility		$306.20	$321.52	$428.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $415.60 / $415.60 / $415.60	Professional		$415.60	$415.60	$415.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $909.23 / $1,062.51 / $1,629.91	Facility		$909.23	$1,062.51	$1,629.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $542.79 / $1,701.10 / $1,933.06	Professional		$542.79	$1,701.10	$1,933.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $327.64 / $513.10 / $653.29	Facility		$327.64	$513.10	$653.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $383.85 / $513.10 / $1,479.13	Facility		$383.85	$513.10	$1,479.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $407.57 / $873.65 / $2,343.00	Professional		$407.57	$873.65	$2,343.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,129.55	Professional		$50.00	$70.00	$1,129.55
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $322.32 / $414.85 / $653.29	Facility		$322.32	$414.85	$653.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $675.35 / $819.56 / $1,179.89	Professional		$675.35	$819.56	$1,179.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,761.50 / $1,761.50 / $1,761.50	Facility		$1,761.50	$1,761.50	$1,761.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,522.89 / $1,747.30 / $2,343.00	Professional		$1,522.89	$1,747.30	$2,343.00
United Facility/Professional Professional Modifier Low / Median / High Price $384.13 / $831.12 / $1,648.40	Professional		$384.13	$831.12	$1,648.40