Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $633.44 / $791.81 / $1,177.15	Facility		$633.44	$791.81	$1,177.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $406.46 / $501.48 / $802.36	Professional		$406.46	$501.48	$802.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,134.92 / $1,372.46 / $1,451.64	Facility		$1,134.92	$1,372.46	$1,451.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.15 / $527.87 / $2,260.98	Professional		$211.15	$527.87	$2,260.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,290.07 / $1,290.07 / $1,340.79	Facility		$1,290.07	$1,290.07	$1,340.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,452.61 / $1,697.48 / $2,603.98	Facility		$1,452.61	$1,697.48	$2,603.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $606.70 / $1,421.45 / $1,615.29	Professional		$606.70	$1,421.45	$1,615.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $406.46 / $633.44 / $1,847.55	Facility		$406.46	$633.44	$1,847.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $475.08 / $633.44 / $1,847.55	Facility		$475.08	$633.44	$1,847.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $263.94 / $316.72 / $1,627.87	Professional		$263.94	$316.72	$1,627.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $527.87	Professional		$50.00	$70.00	$527.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $406.46 / $633.44 / $1,847.55	Facility		$406.46	$633.44	$1,847.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,003.48 / $1,287.32 / $1,765.50	Professional		$1,003.48	$1,287.32	$1,765.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,622.14 / $2,507.38 / $2,507.38	Facility		$1,622.14	$2,507.38	$2,507.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $765.41 / $2,639.35 / $2,639.35	Professional		$765.41	$2,639.35	$2,639.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,124.11 / $1,124.11 / $1,124.11	Professional		$1,124.11	$1,124.11	$1,124.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,534.10 / $2,882.17 / $2,882.17	Professional		$1,534.10	$2,882.17	$2,882.17
United Facility/Professional Professional Modifier Low / Median / High Price $229.47 / $316.72 / $982.58	Professional		$229.47	$316.72	$982.58