Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $621.94 / $621.94 / $1,155.76	Facility		$621.94	$621.94	$1,155.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.08 / $487.18 / $621.94	Professional		$399.08	$487.18	$621.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,114.30 / $1,347.53 / $1,425.27	Facility		$1,114.30	$1,347.53	$1,425.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.31 / $207.31 / $2,219.91	Professional		$207.31	$207.31	$2,219.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $518.28 / $621.94 / $1,316.43	Facility		$518.28	$621.94	$1,316.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $518.28 / $544.19 / $670.02	Professional		$518.28	$544.19	$670.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,426.47 / $1,666.95 / $2,557.14	Facility		$1,426.47	$1,666.95	$2,557.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $595.54 / $1,395.63 / $1,585.94	Professional		$595.54	$1,395.63	$1,585.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $399.08 / $621.94 / $1,813.98	Facility		$399.08	$621.94	$1,813.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $399.08 / $621.94 / $1,813.98	Facility		$399.08	$621.94	$1,813.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $259.14 / $310.97 / $1,598.30	Professional		$259.14	$310.97	$1,598.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $414.62	Professional		$50.00	$70.00	$414.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $399.08 / $621.94 / $1,813.98	Facility		$399.08	$621.94	$1,813.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $931.08 / $1,235.61 / $1,733.04	Professional		$931.08	$1,235.61	$1,733.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,036.56 / $2,461.83 / $2,461.83	Facility		$1,036.56	$2,461.83	$2,461.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $493.28 / $2,073.12 / $2,581.03	Professional		$493.28	$2,073.12	$2,581.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $518.28 / $518.28 / $1,103.70	Professional		$518.28	$518.28	$1,103.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $518.28 / $1,630.39 / $2,829.81	Professional		$518.28	$1,630.39	$2,829.81
United Facility/Professional Professional Modifier Low / Median / High Price $259.14 / $310.97 / $964.73	Professional		$259.14	$310.97	$964.73