Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $770.22 / $770.22 / $1,431.33	Facility		$770.22	$770.22	$1,431.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $494.22 / $609.76 / $770.22	Professional		$494.22	$609.76	$770.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,379.98 / $1,668.81 / $1,765.09	Facility		$1,379.98	$1,668.81	$1,765.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.74 / $256.74 / $2,749.18	Professional		$256.74	$256.74	$2,749.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $641.85 / $770.22 / $1,630.30	Facility		$641.85	$770.22	$1,630.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $641.85 / $673.94 / $829.79	Professional		$641.85	$673.94	$829.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,766.20 / $2,063.94 / $3,166.14	Facility		$1,766.20	$2,063.94	$3,166.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $737.62 / $1,728.38 / $1,964.06	Professional		$737.62	$1,728.38	$1,964.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $494.22 / $770.22 / $2,246.48	Facility		$494.22	$770.22	$2,246.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $494.22 / $770.22 / $2,246.48	Facility		$494.22	$770.22	$2,246.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $320.93 / $385.11 / $1,979.37	Professional		$320.93	$385.11	$1,979.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $513.48	Professional		$50.00	$70.00	$513.48
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $494.22 / $770.22 / $2,246.48	Facility		$494.22	$770.22	$2,246.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,153.09 / $1,530.26 / $2,146.29	Professional		$1,153.09	$1,530.26	$2,146.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,283.70 / $3,048.79 / $3,048.79	Facility		$1,283.70	$3,048.79	$3,048.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $610.87 / $2,567.40 / $3,196.41	Professional		$610.87	$2,567.40	$3,196.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $641.85 / $641.85 / $1,366.85	Professional		$641.85	$641.85	$1,366.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $641.85 / $1,865.35 / $3,504.50	Professional		$641.85	$1,865.35	$3,504.50
United Facility/Professional Professional Modifier Low / Median / High Price $288.83 / $385.11 / $1,347.89	Professional		$288.83	$385.11	$1,347.89