Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $811.80 / $811.80 / $1,508.59	Facility		$811.80	$811.80	$1,508.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $520.91 / $642.67 / $1,014.75	Professional		$520.91	$642.67	$1,014.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,454.48 / $1,758.90 / $1,860.38	Facility		$1,454.48	$1,758.90	$1,860.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.15 / $142.57 / $2,706.00	Professional		$113.15	$142.57	$2,706.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $676.50 / $811.80 / $1,718.31	Facility		$676.50	$811.80	$1,718.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $676.50 / $710.33 / $874.55	Professional		$676.50	$710.33	$874.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,861.71 / $2,175.56 / $3,337.36	Facility		$1,861.71	$2,175.56	$3,337.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $777.27 / $1,821.68 / $2,070.09	Professional		$777.27	$1,821.68	$2,070.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $520.91 / $811.80 / $2,367.75	Facility		$520.91	$811.80	$2,367.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $520.91 / $811.80 / $2,367.75	Facility		$520.91	$811.80	$2,367.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $141.44 / $181.81 / $1,018.37	Professional		$141.44	$181.81	$1,018.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $676.50	Professional		$50.00	$70.00	$676.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $520.91 / $811.80 / $2,367.75	Facility		$520.91	$811.80	$2,367.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,215.29 / $1,612.79 / $2,262.04	Professional		$1,215.29	$1,612.79	$2,262.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,598.00 / $3,213.38 / $3,213.38	Facility		$1,598.00	$3,213.38	$3,213.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $980.93 / $2,706.00 / $3,368.97	Professional		$980.93	$2,706.00	$3,368.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $282.88 / $1,440.64	Professional		$282.88	$282.88	$1,440.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $282.88 / $282.88 / $3,693.69	Professional		$282.88	$282.88	$3,693.69
United Facility/Professional Professional Modifier Low / Median / High Price $152.25 / $226.30 / $750.22	Professional		$152.25	$226.30	$750.22