Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $336.00 / $420.00 / $624.40	Facility		$336.00	$420.00	$624.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.60 / $266.00 / $425.60	Professional		$215.60	$266.00	$425.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.00 / $728.00 / $770.00	Facility		$602.00	$728.00	$770.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.00 / $280.00 / $1,199.29	Professional		$112.00	$280.00	$1,199.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $684.29 / $684.29 / $711.20	Facility		$684.29	$684.29	$711.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $770.46 / $900.34 / $1,381.15	Facility		$770.46	$900.34	$1,381.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.73 / $753.98 / $856.80	Professional		$321.73	$753.98	$856.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $215.60 / $336.00 / $980.00	Facility		$215.60	$336.00	$980.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $252.00 / $336.00 / $980.00	Facility		$252.00	$336.00	$980.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $168.00 / $863.48	Professional		$140.00	$168.00	$863.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $140.00	Professional		$50.00	$70.00	$140.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $215.60 / $336.00 / $980.00	Facility		$215.60	$336.00	$980.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $532.54 / $683.10 / $936.84	Professional		$532.54	$683.10	$936.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $560.00 / $1,330.00 / $1,330.00	Facility		$560.00	$1,330.00	$1,330.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $406.00 / $1,400.00 / $1,400.00	Professional		$406.00	$1,400.00	$1,400.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $596.27 / $596.27 / $596.27	Professional		$596.27	$596.27	$596.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $813.74 / $1,528.80 / $1,528.80	Professional		$813.74	$1,528.80	$1,528.80
United Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $168.00 / $588.00	Professional		$126.00	$168.00	$588.00