Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $910.03 / $1,137.54 / $1,691.14	Facility		$910.03	$1,137.54	$1,691.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $583.94 / $720.44 / $1,152.71	Professional		$583.94	$720.44	$1,152.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,630.47 / $1,971.74 / $2,085.48	Facility		$1,630.47	$1,971.74	$2,085.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.33 / $758.36 / $3,248.21	Professional		$303.33	$758.36	$3,248.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,853.36 / $1,853.36 / $1,926.23	Facility		$1,853.36	$1,853.36	$1,926.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,086.98 / $2,438.82 / $3,741.21	Facility		$2,086.98	$2,438.82	$3,741.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $871.43 / $2,042.12 / $2,320.59	Professional		$871.43	$2,042.12	$2,320.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $583.94 / $910.03 / $2,654.26	Facility		$583.94	$910.03	$2,654.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $682.52 / $910.03 / $2,654.26	Facility		$682.52	$910.03	$2,654.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $379.18 / $455.02 / $2,338.67	Professional		$379.18	$455.02	$2,338.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $437.54	Professional		$50.00	$70.00	$437.54
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $583.94 / $910.03 / $2,654.26	Facility		$583.94	$910.03	$2,654.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,442.24 / $1,848.95 / $2,535.73	Professional		$1,442.24	$1,848.95	$2,535.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,516.72 / $3,602.21 / $3,602.21	Facility		$1,516.72	$3,602.21	$3,602.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,099.61 / $3,791.80 / $3,791.80	Professional		$1,099.61	$3,791.80	$3,791.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,614.96 / $1,614.96 / $1,614.96	Professional		$1,614.96	$1,614.96	$1,614.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,203.96 / $4,140.64 / $4,140.64	Professional		$2,203.96	$4,140.64	$4,140.64
United Facility/Professional Facility Modifier Low / Median / High Price $758.36 / $758.36 / $758.36	Facility		$758.36	$758.36	$758.36
United Facility/Professional Professional Modifier Low / Median / High Price $341.26 / $455.02 / $1,411.61	Professional		$341.26	$455.02	$1,411.61