Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $369.60 / $369.60 / $686.84	Facility		$369.60	$369.60	$686.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.80 / $289.52 / $369.60	Professional		$184.80	$289.52	$369.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $662.20 / $800.80 / $847.00	Facility		$662.20	$800.80	$847.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.20 / $123.20 / $1,319.23	Professional		$123.20	$123.20	$1,319.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $782.32 / $782.32 / $782.32	Facility		$782.32	$782.32	$782.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $847.95 / $990.90 / $1,520.07	Facility		$847.95	$990.90	$1,520.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.94 / $829.38 / $942.48	Professional		$353.94	$829.38	$942.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $237.16 / $369.60 / $1,078.00	Facility		$237.16	$369.60	$1,078.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $237.16 / $369.60 / $1,078.00	Facility		$237.16	$369.60	$1,078.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.00 / $184.80 / $949.83	Professional		$154.00	$184.80	$949.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $246.40	Professional		$50.00	$70.00	$246.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $237.16 / $369.60 / $1,078.00	Facility		$237.16	$369.60	$1,078.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $553.29 / $734.28 / $1,029.86	Professional		$553.29	$734.28	$1,029.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $616.00 / $1,463.00 / $1,463.00	Facility		$616.00	$1,463.00	$1,463.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $293.31 / $1,232.00 / $1,533.84	Professional		$293.31	$1,232.00	$1,533.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $308.00 / $308.00 / $655.90	Professional		$308.00	$308.00	$655.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $308.00 / $895.11 / $1,681.68	Professional		$308.00	$895.11	$1,681.68
United Facility/Professional Facility Modifier Low / Median / High Price $308.00 / $308.00 / $308.00	Facility		$308.00	$308.00	$308.00
United Facility/Professional Professional Modifier Low / Median / High Price $133.88 / $184.80 / $646.79	Professional		$133.88	$184.80	$646.79