Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $910.86 / $1,138.57 / $1,692.68	Facility		$910.86	$1,138.57	$1,692.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.43 / $713.51 / $910.86	Professional		$455.43	$713.51	$910.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,631.96 / $1,973.53 / $2,087.39	Facility		$1,631.96	$1,973.53	$2,087.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.62 / $523.74 / $3,251.17	Professional		$303.62	$523.74	$3,251.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $759.05 / $910.86 / $1,927.99	Facility		$759.05	$910.86	$1,927.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $759.05 / $759.05 / $981.62	Professional		$759.05	$759.05	$981.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,088.80 / $2,440.92 / $3,744.44	Facility		$2,088.80	$2,440.92	$3,744.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $872.26 / $1,915.46 / $2,322.69	Professional		$872.26	$1,915.46	$2,322.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $455.43 / $683.15 / $1,492.32	Facility		$455.43	$683.15	$1,492.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $455.43 / $713.51 / $3,605.49	Facility		$455.43	$713.51	$3,605.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $401.17 / $607.24 / $2,102.57	Professional		$401.17	$607.24	$2,102.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $759.05	Professional		$55.00	$85.00	$759.05
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $455.43 / $683.15 / $1,492.32	Facility		$455.43	$683.15	$1,492.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,267.38 / $1,810.24 / $2,538.98	Professional		$1,267.38	$1,810.24	$2,538.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,518.10 / $1,518.10 / $3,605.49	Facility		$1,518.10	$1,518.10	$3,605.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $742.74 / $3,795.25 / $3,795.25	Professional		$742.74	$3,795.25	$3,795.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $601.75 / $601.75 / $1,616.43	Professional		$601.75	$601.75	$1,616.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $601.75 / $683.15 / $4,144.41	Professional		$601.75	$683.15	$4,144.41
United Facility/Professional Facility Modifier Low / Median / High Price $607.24 / $607.24 / $1,647.14	Facility		$607.24	$607.24	$1,647.14
United Facility/Professional Professional Modifier Low / Median / High Price $401.17 / $607.24 / $1,421.62	Professional		$401.17	$607.24	$1,421.62