Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $541.09 / $676.37 / $1,005.53	Facility		$541.09	$676.37	$1,005.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.20 / $428.36 / $685.38	Professional		$347.20	$428.36	$685.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $969.46 / $1,172.36 / $1,240.00	Facility		$969.46	$1,172.36	$1,240.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.36 / $450.46 / $1,931.34	Professional		$180.36	$450.46	$1,931.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $450.91 / $669.72 / $1,145.31	Facility		$450.91	$669.72	$1,145.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $450.91 / $473.46 / $583.02	Professional		$450.91	$473.46	$583.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,240.83 / $1,450.02 / $2,224.37	Facility		$1,240.83	$1,450.02	$2,224.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $518.32 / $1,214.21 / $1,379.79	Professional		$518.32	$1,214.21	$1,379.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $347.20 / $541.09 / $1,578.19	Facility		$347.20	$541.09	$1,578.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $405.82 / $541.09 / $1,578.19	Facility		$405.82	$541.09	$1,578.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $225.46 / $272.44 / $1,390.54	Professional		$225.46	$272.44	$1,390.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $225.46	Professional		$50.00	$70.00	$225.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $347.20 / $541.09 / $1,578.19	Facility		$347.20	$541.09	$1,578.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $862.47 / $1,099.58 / $1,508.03	Professional		$862.47	$1,099.58	$1,508.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $901.82 / $2,141.82 / $2,141.82	Facility		$901.82	$2,141.82	$2,141.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $653.82 / $2,254.55 / $2,254.55	Professional		$653.82	$2,254.55	$2,254.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $340.55 / $340.55 / $960.23	Professional		$340.55	$340.55	$960.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $340.55 / $340.55 / $2,461.96	Professional		$340.55	$340.55	$2,461.96
United Facility/Professional Professional Modifier Low / Median / High Price $196.01 / $270.95 / $839.32	Professional		$196.01	$270.95	$839.32