Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $936.00 / $1,170.00 / $1,739.40	Facility		$936.00	$1,170.00	$1,739.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $600.60 / $741.00 / $1,185.59	Professional		$600.60	$741.00	$1,185.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,677.00 / $2,028.00 / $2,145.00	Facility		$1,677.00	$2,028.00	$2,145.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $312.00 / $780.00 / $3,340.91	Professional		$312.00	$780.00	$3,340.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $780.00 / $1,158.50 / $1,981.20	Facility		$780.00	$1,158.50	$1,981.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $780.00 / $819.00 / $1,008.38	Professional		$780.00	$819.00	$1,008.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,146.46 / $2,508.32 / $3,847.82	Facility		$2,146.46	$2,508.32	$3,847.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $896.21 / $2,100.38 / $2,386.80	Professional		$896.21	$2,100.38	$2,386.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $600.60 / $936.00 / $2,730.00	Facility		$600.60	$936.00	$2,730.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $936.00 / $2,730.00	Facility		$702.00	$936.00	$2,730.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $390.00 / $468.00 / $2,405.40	Professional		$390.00	$468.00	$2,405.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $599.94	Professional		$50.00	$70.00	$599.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $600.60 / $936.00 / $2,730.00	Facility		$600.60	$936.00	$2,730.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,483.31 / $1,901.80 / $2,608.21	Professional		$1,483.31	$1,901.80	$2,608.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,560.00 / $3,705.00 / $3,705.00	Facility		$1,560.00	$3,705.00	$3,705.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,131.00 / $3,900.00 / $3,900.00	Professional		$1,131.00	$3,900.00	$3,900.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $780.00 / $780.00 / $1,661.04	Professional		$780.00	$780.00	$1,661.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $780.00 / $780.00 / $4,258.80	Professional		$780.00	$780.00	$4,258.80
United Facility/Professional Professional Modifier Low / Median / High Price $339.07 / $468.00 / $1,638.00	Professional		$339.07	$468.00	$1,638.00