Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $450.30 / $562.88 / $836.81	Facility		$450.30	$562.88	$836.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.94 / $356.49 / $570.38	Professional		$288.94	$356.49	$570.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $806.79 / $975.65 / $1,031.94	Facility		$806.79	$975.65	$1,031.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.10 / $375.25 / $1,607.27	Professional		$150.10	$375.25	$1,607.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $953.14 / $993.50 / $993.50	Facility		$953.14	$993.50	$993.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,032.68 / $1,206.77 / $1,851.22	Facility		$1,032.68	$1,206.77	$1,851.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $431.17 / $1,010.47 / $1,148.26	Professional		$431.17	$1,010.47	$1,148.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $288.94 / $450.30 / $1,313.38	Facility		$288.94	$450.30	$1,313.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $337.73 / $450.30 / $1,313.38	Facility		$337.73	$450.30	$1,313.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.63 / $225.15 / $1,157.21	Professional		$187.63	$225.15	$1,157.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,035.69	Professional		$50.00	$70.00	$1,035.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $288.94 / $450.30 / $1,313.38	Facility		$288.94	$450.30	$1,313.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $713.25 / $915.01 / $1,254.89	Professional		$713.25	$915.01	$1,254.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $750.50 / $1,782.44 / $1,782.44	Facility		$750.50	$1,782.44	$1,782.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $346.12 / $1,876.25 / $1,876.25	Professional		$346.12	$1,876.25	$1,876.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $799.11 / $799.11 / $799.11	Professional		$799.11	$799.11	$799.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,090.56 / $2,048.87 / $2,048.87	Professional		$1,090.56	$2,048.87	$2,048.87
United Facility/Professional Professional Modifier Low / Median / High Price $163.12 / $225.15 / $698.49	Professional		$163.12	$225.15	$698.49