Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $522.08 / $652.61 / $970.21	Facility		$522.08	$652.61	$970.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $335.00 / $413.32 / $661.31	Professional		$335.00	$413.32	$661.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $935.40 / $1,131.18 / $1,196.44	Facility		$935.40	$1,131.18	$1,196.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.03 / $435.07 / $1,863.49	Professional		$174.03	$435.07	$1,863.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,063.27 / $1,063.27 / $1,105.08	Facility		$1,063.27	$1,063.27	$1,105.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,197.58 / $1,399.48 / $2,146.83	Facility		$1,197.58	$1,399.48	$2,146.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $500.14 / $1,171.56 / $1,331.31	Professional		$500.14	$1,171.56	$1,331.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $335.00 / $522.08 / $1,522.75	Facility		$335.00	$522.08	$1,522.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $391.56 / $522.08 / $1,522.75	Facility		$391.56	$522.08	$1,522.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $217.54 / $261.04 / $1,341.69	Professional		$217.54	$261.04	$1,341.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $217.54	Professional		$50.00	$70.00	$217.54
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $335.00 / $522.08 / $1,522.75	Facility		$335.00	$522.08	$1,522.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $827.56 / $1,060.94 / $1,455.02	Professional		$827.56	$1,060.94	$1,455.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $870.14 / $2,066.58 / $2,066.58	Facility		$870.14	$2,066.58	$2,066.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $630.85 / $2,175.35 / $2,175.35	Professional		$630.85	$2,175.35	$2,175.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $926.50 / $926.50 / $926.50	Professional		$926.50	$926.50	$926.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,264.41 / $2,375.48 / $2,375.48	Professional		$1,264.41	$2,375.48	$2,375.48
United Facility/Professional Professional Modifier Low / Median / High Price $182.73 / $261.04 / $809.84	Professional		$182.73	$261.04	$809.84