Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,008.78 / $1,260.98 / $1,874.65	Facility		$1,008.78	$1,260.98	$1,874.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $672.52 / $790.21 / $1,008.78	Professional		$672.52	$790.21	$1,008.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,807.40 / $2,185.69 / $2,311.79	Facility		$1,807.40	$2,185.69	$2,311.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $336.26 / $580.04 / $3,561.39	Professional		$336.26	$580.04	$3,561.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $759.11 / $2,054.46 / $2,135.25	Facility		$759.11	$2,054.46	$2,135.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,313.17 / $2,703.13 / $4,146.67	Facility		$2,313.17	$2,703.13	$4,146.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $966.01 / $2,263.69 / $2,572.39	Professional		$966.01	$2,263.69	$2,572.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $504.39 / $756.59 / $1,652.75	Facility		$504.39	$756.59	$1,652.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $504.39 / $790.21 / $3,993.09	Facility		$504.39	$790.21	$3,993.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $353.07 / $590.61 / $2,328.60	Professional		$353.07	$590.61	$2,328.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $2,320.19	Professional		$55.00	$85.00	$2,320.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $504.39 / $756.59 / $1,652.75	Facility		$504.39	$756.59	$1,652.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,126.69 / $2,004.61 / $2,811.60	Professional		$1,126.69	$2,004.61	$2,811.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,681.30 / $1,681.30 / $3,993.09	Facility		$1,681.30	$1,681.30	$3,993.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,218.94 / $4,203.25 / $4,203.25	Professional		$1,218.94	$4,203.25	$4,203.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $442.96 / $442.96 / $1,790.20	Professional		$442.96	$442.96	$1,790.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $442.96 / $756.59 / $4,589.95	Professional		$442.96	$756.59	$4,589.95
United Facility/Professional Professional Modifier Low / Median / High Price $354.37 / $504.39 / $1,564.79	Professional		$354.37	$504.39	$1,564.79