Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $384.00 / $480.00 / $1,026.08	Facility		$384.00	$480.00	$1,026.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.40 / $304.00 / $486.40	Professional		$246.40	$304.00	$486.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $688.00 / $832.00 / $880.00	Facility		$688.00	$832.00	$880.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.00 / $320.00 / $1,370.62	Professional		$128.00	$320.00	$1,370.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $782.05 / $782.05 / $812.80	Facility		$782.05	$782.05	$812.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $880.39 / $1,028.81 / $1,578.22	Facility		$880.39	$1,028.81	$1,578.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $367.57 / $861.70 / $979.20	Professional		$367.57	$861.70	$979.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $246.40 / $384.00 / $1,120.00	Facility		$246.40	$384.00	$1,120.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $288.00 / $384.00 / $1,120.00	Facility		$288.00	$384.00	$1,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $192.00 / $986.83	Professional		$160.00	$192.00	$986.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $883.20	Professional		$50.00	$70.00	$883.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $246.40 / $384.00 / $1,120.00	Facility		$246.40	$384.00	$1,120.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $608.52 / $780.12 / $1,069.90	Professional		$608.52	$780.12	$1,069.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $1,520.00 / $1,520.00	Facility		$640.00	$1,520.00	$1,520.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $464.00 / $1,600.00 / $1,600.00	Professional		$464.00	$1,600.00	$1,600.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $681.45 / $681.45 / $681.45	Professional		$681.45	$681.45	$681.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $929.99 / $1,747.20 / $1,747.20	Professional		$929.99	$1,747.20	$1,747.20
United Facility/Professional Professional Modifier Low / Median / High Price $139.10 / $192.00 / $672.00	Professional		$139.10	$192.00	$672.00