Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $695.35 / $869.19 / $1,292.20	Facility		$695.35	$869.19	$1,292.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.16 / $544.69 / $695.35	Professional		$475.16	$544.69	$695.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,245.83 / $1,506.60 / $1,593.52	Facility		$1,245.83	$1,506.60	$1,593.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.78 / $231.78 / $2,317.84	Professional		$231.78	$231.78	$2,317.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $523.25 / $1,416.15 / $1,471.83	Facility		$523.25	$1,416.15	$1,471.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,594.98 / $1,863.86 / $2,859.21	Facility		$1,594.98	$1,863.86	$2,859.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $665.76 / $1,560.37 / $1,773.15	Professional		$665.76	$1,560.37	$1,773.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $259.73 / $259.73 / $695.35	Facility		$259.73	$259.73	$695.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $259.73 / $475.16 / $2,752.44	Facility		$259.73	$475.16	$2,752.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $211.26 / $463.57 / $1,043.03	Professional		$211.26	$463.57	$1,043.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $286.83 / $869.19	Professional		$55.00	$286.83	$869.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $259.73 / $259.73 / $695.35	Facility		$259.73	$259.73	$695.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $680.58 / $1,381.40 / $1,937.50	Professional		$680.58	$1,381.40	$1,937.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,158.92 / $1,158.92 / $2,752.44	Facility		$1,158.92	$1,158.92	$2,752.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $264.24 / $264.24 / $264.24	Professional		$264.24	$264.24	$264.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $265.92 / $265.92 / $1,233.99	Professional		$265.92	$265.92	$1,233.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $265.92 / $3,042.17 / $3,163.85	Professional		$265.92	$3,042.17	$3,163.85
United Facility/Professional Professional Modifier Low / Median / High Price $243.37 / $463.57 / $1,078.60	Professional		$243.37	$463.57	$1,078.60