Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $720.00 / $900.00 / $1,338.00	Facility		$720.00	$900.00	$1,338.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $462.00 / $570.00 / $911.70	Professional		$462.00	$570.00	$911.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,290.00 / $1,560.00 / $1,650.00	Facility		$1,290.00	$1,560.00	$1,650.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $554.28 / $599.20 / $2,580.00	Professional		$554.28	$599.20	$2,580.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $891.16 / $1,524.00	Facility		$600.00	$891.16	$1,524.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $600.00 / $630.00 / $775.83	Professional		$600.00	$630.00	$775.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,650.85 / $1,929.15 / $2,959.37	Facility		$1,650.85	$1,929.15	$2,959.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $689.71 / $1,615.68 / $1,836.00	Professional		$689.71	$1,615.68	$1,836.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $462.00 / $720.00 / $2,100.00	Facility		$462.00	$720.00	$2,100.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $720.00 / $2,100.00	Facility		$540.00	$720.00	$2,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $299.89 / $362.40 / $1,850.31	Professional		$299.89	$362.40	$1,850.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $480.56	Professional		$50.00	$70.00	$480.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $462.00 / $720.00 / $2,100.00	Facility		$462.00	$720.00	$2,100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,147.22 / $1,463.22 / $2,006.74	Professional		$1,147.22	$1,463.22	$2,006.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $2,850.00 / $2,850.00	Facility		$1,200.00	$2,850.00	$2,850.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $870.00 / $3,000.00 / $3,000.00	Professional		$870.00	$3,000.00	$3,000.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $453.00 / $453.00 / $1,277.73	Professional		$453.00	$453.00	$1,277.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $453.00 / $453.00 / $3,276.00	Professional		$453.00	$453.00	$3,276.00
United Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $480.00 / $1,302.00	Facility		$480.00	$480.00	$1,302.00
United Facility/Professional Professional Modifier Low / Median / High Price $299.89 / $360.42 / $1,261.47	Professional		$299.89	$360.42	$1,261.47