Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $717.49 / $1,333.34 / $2,456.80	Facility		$717.49	$1,333.34	$2,456.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $448.43 / $460.39 / $717.49	Professional		$448.43	$460.39	$717.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,285.51 / $1,554.57 / $1,644.25	Facility		$1,285.51	$1,554.57	$1,644.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.16 / $412.55 / $2,560.96	Professional		$239.16	$412.55	$2,560.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $449.93 / $1,461.24 / $1,518.69	Facility		$449.93	$1,461.24	$1,518.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,645.45 / $1,922.83 / $2,949.67	Facility		$1,645.45	$1,922.83	$2,949.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $686.82 / $1,610.05 / $1,829.60	Professional		$686.82	$1,610.05	$1,829.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $538.12 / $1,046.33 / $1,286.21	Facility		$538.12	$1,046.33	$1,286.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $490.29 / $1,175.51 / $3,191.10	Facility		$490.29	$1,175.51	$3,191.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.19 / $358.75 / $1,656.21	Professional		$49.19	$358.75	$1,656.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $1,650.23	Professional		$55.00	$85.00	$1,650.23
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $538.12 / $1,046.33 / $1,286.21	Facility		$538.12	$1,046.33	$1,286.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,074.06 / $1,457.70 / $1,999.17	Professional		$1,074.06	$1,457.70	$1,999.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,195.82 / $3,191.10 / $3,191.10	Facility		$1,195.82	$3,191.10	$3,191.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $316.89 / $2,989.55 / $2,989.55	Professional		$316.89	$2,989.55	$2,989.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $451.58 / $451.58 / $1,273.28	Professional		$451.58	$451.58	$1,273.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $451.58 / $451.58 / $3,264.59	Professional		$451.58	$451.58	$3,264.59
United Facility/Professional Professional Modifier Low / Median / High Price $49.23 / $358.75 / $926.76	Professional		$49.23	$358.75	$926.76