Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $431.04 / $834.90 / $1,439.68	Facility		$431.04	$834.90	$1,439.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.79 / $539.54 / $849.44	Professional		$361.79	$539.54	$849.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,196.69 / $1,447.16 / $1,530.65	Facility		$1,196.69	$1,447.16	$1,530.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.64 / $556.60 / $2,384.03	Professional		$222.64	$556.60	$2,384.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $556.60 / $826.70 / $1,413.76	Facility		$556.60	$826.70	$1,413.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $556.60 / $584.42 / $719.79	Professional		$556.60	$584.42	$719.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,531.90 / $1,790.15 / $2,746.14	Facility		$1,531.90	$1,790.15	$2,746.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $639.74 / $1,498.82 / $1,703.20	Professional		$639.74	$1,498.82	$1,703.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $428.58 / $667.92 / $1,948.10	Facility		$428.58	$667.92	$1,948.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $428.58 / $667.92 / $1,948.10	Facility		$428.58	$667.92	$1,948.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $278.30 / $333.96 / $1,716.47	Professional		$278.30	$333.96	$1,716.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $556.60	Professional		$50.00	$70.00	$556.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $428.58 / $667.92 / $1,948.10	Facility		$428.58	$667.92	$1,948.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,058.24 / $1,357.52 / $1,861.78	Professional		$1,058.24	$1,357.52	$1,861.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,113.20 / $2,643.85 / $2,643.85	Facility		$1,113.20	$2,643.85	$2,643.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $807.07 / $2,783.00 / $2,783.00	Professional		$807.07	$2,783.00	$2,783.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $556.60 / $556.60 / $1,185.30	Professional		$556.60	$556.60	$1,185.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $556.60 / $556.60 / $3,039.04	Professional		$556.60	$556.60	$3,039.04
United Facility/Professional Professional Modifier Low / Median / High Price $241.95 / $333.96 / $1,036.06	Professional		$241.95	$333.96	$1,036.06