Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $397.20 / $496.50 / $738.13	Facility		$397.20	$496.50	$738.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.87 / $314.45 / $496.50	Professional		$254.87	$314.45	$496.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $711.65 / $860.60 / $910.25	Facility		$711.65	$860.60	$910.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.40 / $258.41 / $1,417.75	Professional		$132.40	$258.41	$1,417.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $808.93 / $808.93 / $840.74	Facility		$808.93	$808.93	$840.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $911.03 / $1,064.60 / $1,633.14	Facility		$911.03	$1,064.60	$1,633.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.37 / $891.32 / $1,012.86	Professional		$380.37	$891.32	$1,012.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $254.87 / $397.20 / $1,158.50	Facility		$254.87	$397.20	$1,158.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $297.89 / $397.20 / $1,158.50	Facility		$297.89	$397.20	$1,158.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.47 / $198.60 / $1,020.75	Professional		$142.47	$198.60	$1,020.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $165.50	Professional		$50.00	$70.00	$165.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $254.87 / $397.20 / $1,158.50	Facility		$254.87	$397.20	$1,158.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $494.89 / $806.75 / $1,106.68	Professional		$494.89	$806.75	$1,106.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $662.00 / $1,572.25 / $1,572.25	Facility		$662.00	$1,572.25	$1,572.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $479.95 / $1,655.00 / $1,655.00	Professional		$479.95	$1,655.00	$1,655.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $195.36 / $195.36 / $704.88	Professional		$195.36	$195.36	$704.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $195.36 / $757.01 / $1,807.26	Professional		$195.36	$757.01	$1,807.26
United Facility/Professional Facility Modifier Low / Median / High Price $397.20 / $397.20 / $397.20	Facility		$397.20	$397.20	$397.20
United Facility/Professional Professional Modifier Low / Median / High Price $139.02 / $198.60 / $638.12	Professional		$139.02	$198.60	$638.12