Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $360.00 / $450.00 / $669.00	Facility		$360.00	$450.00	$669.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.00 / $285.00 / $450.00	Professional		$231.00	$285.00	$450.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $780.00 / $825.00	Facility		$645.00	$780.00	$825.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $120.00 / $1,200.00	Professional		$120.00	$120.00	$1,200.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $733.17 / $733.17 / $762.00	Facility		$733.17	$733.17	$762.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $825.43 / $964.58 / $1,479.68	Facility		$825.43	$964.58	$1,479.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.44 / $807.84 / $918.00	Professional		$344.44	$807.84	$918.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $231.00 / $360.00 / $1,050.00	Facility		$231.00	$360.00	$1,050.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $270.00 / $360.00 / $1,050.00	Facility		$270.00	$360.00	$1,050.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.43 / $180.00 / $925.16	Professional		$52.43	$180.00	$925.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $828.00	Professional		$50.00	$70.00	$828.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $231.00 / $360.00 / $1,050.00	Facility		$231.00	$360.00	$1,050.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $167.02 / $715.00 / $1,002.83	Professional		$167.02	$715.00	$1,002.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $1,425.00 / $1,425.00	Facility		$600.00	$1,425.00	$1,425.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $435.00 / $1,500.00 / $1,500.00	Professional		$435.00	$1,500.00	$1,500.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $66.06 / $638.86	Professional		$66.06	$66.06	$638.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $255.98 / $1,638.00	Professional		$66.06	$255.98	$1,638.00
United Facility/Professional Facility Modifier Low / Median / High Price $360.00 / $360.00 / $360.00	Facility		$360.00	$360.00	$360.00
United Facility/Professional Professional Modifier Low / Median / High Price $52.56 / $180.00 / $465.00	Professional		$52.56	$180.00	$465.00