Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $701.88 / $701.88 / $1,304.33	Facility		$701.88	$701.88	$1,304.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $368.49 / $549.80 / $701.88	Professional		$368.49	$549.80	$701.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,257.54 / $1,520.74 / $1,608.48	Facility		$1,257.54	$1,520.74	$1,608.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.83 / $403.58 / $2,515.07	Professional		$288.83	$403.58	$2,515.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $462.15 / $1,588.27 / $1,650.72	Facility		$462.15	$1,588.27	$1,650.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,609.40 / $1,880.71 / $2,885.06	Facility		$1,609.40	$1,880.71	$2,885.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $671.95 / $1,476.00 / $1,789.80	Professional		$671.95	$1,476.00	$1,789.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $526.41 / $1,023.58 / $2,057.92	Facility		$526.41	$1,023.58	$2,057.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $479.62 / $1,169.80 / $2,828.48	Facility		$479.62	$1,169.80	$2,828.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $339.24 / $481.40 / $1,976.31	Professional		$339.24	$481.40	$1,976.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $584.90	Professional		$55.00	$85.00	$584.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $526.41 / $1,023.58 / $2,057.92	Facility		$526.41	$1,023.58	$2,057.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,050.81 / $1,431.94 / $1,988.80	Professional		$1,050.81	$1,431.94	$1,988.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,169.80 / $2,828.48 / $2,828.48	Facility		$1,169.80	$2,828.48	$2,828.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $310.00 / $2,924.50 / $2,924.50	Professional		$310.00	$2,924.50	$2,924.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $601.75 / $601.75 / $1,245.57	Professional		$601.75	$601.75	$1,245.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $601.75 / $2,331.73 / $3,193.55	Professional		$601.75	$2,331.73	$3,193.55
United Facility/Professional Professional Modifier Low / Median / High Price $336.98 / $481.40 / $1,421.62	Professional		$336.98	$481.40	$1,421.62