Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $1,031.01 / $1,406.72	Facility		$200.00	$1,031.01	$1,406.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $719.94 / $1,028.28 / $1,406.72	Professional		$719.94	$1,028.28	$1,406.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $665.17 / $1,540.66 / $4,306.33	Professional		$665.17	$1,540.66	$4,306.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,886.04 / $2,203.98 / $3,380.98	Facility		$1,886.04	$2,203.98	$3,380.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $902.39 / $3,057.51 / $3,474.44	Professional		$902.39	$3,057.51	$3,474.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $380.25 / $800.27 / $1,285.82	Facility		$380.25	$800.27	$1,285.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $380.25 / $810.98 / $1,332.86	Facility		$380.25	$810.98	$1,332.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $625.21 / $1,544.66 / $4,681.14	Professional		$625.21	$1,544.66	$4,681.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.81 / $503.39 / $1,243.68	Professional		$55.81	$503.39	$1,243.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $380.25 / $810.98 / $1,285.82	Facility		$380.25	$810.98	$1,285.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $349.57 / $1,594.16 / $2,908.03	Professional		$349.57	$1,594.16	$2,908.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,059.41 / $3,059.41 / $3,059.41	Facility		$3,059.41	$3,059.41	$3,059.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,012.91 / $3,304.05 / $4,681.14	Professional		$1,012.91	$3,304.05	$4,681.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,306.26 / $2,306.26 / $2,306.26	Professional		$2,306.26	$2,306.26	$2,306.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,859.39 / $4,198.45 / $4,198.45	Professional		$2,859.39	$4,198.45	$4,198.45
United Facility/Professional Professional Modifier Low / Median / High Price $625.21 / $1,506.65 / $3,117.04	Professional		$625.21	$1,506.65	$3,117.04