Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $604.79 / $756.00 / $1,123.92	Facility		$604.79	$756.00	$1,123.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $403.20 / $473.76 / $604.79	Professional		$403.20	$473.76	$604.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,083.59 / $1,310.40 / $1,386.00	Facility		$1,083.59	$1,310.40	$1,386.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.60 / $347.76 / $2,158.73	Professional		$201.60	$347.76	$2,158.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $382.87 / $1,231.73 / $1,280.16	Facility		$382.87	$1,231.73	$1,280.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,386.82 / $1,620.61 / $2,486.06	Facility		$1,386.82	$1,620.61	$2,486.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $579.03 / $800.00 / $1,542.24	Professional		$579.03	$800.00	$1,542.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $302.39 / $453.60 / $990.89	Facility		$302.39	$453.60	$990.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $302.39 / $473.76 / $2,394.00	Facility		$302.39	$473.76	$2,394.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $252.00 / $403.20 / $1,396.08	Professional		$252.00	$403.20	$1,396.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $504.00	Professional		$55.00	$85.00	$504.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $302.39 / $453.60 / $990.89	Facility		$302.39	$453.60	$990.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $841.32 / $1,201.69 / $1,685.44	Professional		$841.32	$1,201.69	$1,685.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $267.12 / $1,008.00 / $2,394.00	Facility		$267.12	$1,008.00	$2,394.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $267.12 / $2,520.00 / $2,520.00	Professional		$267.12	$2,520.00	$2,520.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $504.00 / $504.00 / $1,073.29	Professional		$504.00	$504.00	$1,073.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $504.00 / $504.00 / $2,751.84	Professional		$504.00	$504.00	$2,751.84
United Facility/Professional Professional Modifier Low / Median / High Price $226.80 / $302.39 / $1,058.40	Professional		$226.80	$302.39	$1,058.40