Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.00 / $1,140.00 / $1,694.80	Facility		$912.00	$1,140.00	$1,694.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $585.20 / $722.00 / $1,140.00	Professional		$585.20	$722.00	$1,140.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,634.00 / $1,976.00 / $2,090.00	Facility		$1,634.00	$1,976.00	$2,090.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $304.00 / $602.10 / $3,255.24	Professional		$304.00	$602.10	$3,255.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,857.37 / $1,857.37 / $1,930.40	Facility		$1,857.37	$1,857.37	$1,930.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,091.50 / $2,444.08 / $3,749.29	Facility		$2,091.50	$2,444.08	$3,749.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $873.50 / $2,046.53 / $2,325.60	Professional		$873.50	$2,046.53	$2,325.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $585.20 / $912.00 / $2,660.00	Facility		$585.20	$912.00	$2,660.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $684.00 / $912.00 / $2,660.00	Facility		$684.00	$912.00	$2,660.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $330.37 / $456.00 / $2,343.73	Professional		$330.37	$456.00	$2,343.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $380.00	Professional		$50.00	$70.00	$380.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $585.20 / $912.00 / $2,660.00	Facility		$585.20	$912.00	$2,660.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,148.58 / $1,815.19 / $2,542.23	Professional		$1,148.58	$1,815.19	$2,542.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,520.00 / $3,610.00 / $3,610.00	Facility		$1,520.00	$3,610.00	$3,610.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $557.39 / $3,800.00 / $3,800.00	Professional		$557.39	$3,800.00	$3,800.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $451.58 / $451.58 / $1,618.45	Professional		$451.58	$451.58	$1,618.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $451.58 / $451.58 / $4,149.60	Professional		$451.58	$451.58	$4,149.60
United Facility/Professional Professional Modifier Low / Median / High Price $319.20 / $456.00 / $1,264.41	Professional		$319.20	$456.00	$1,264.41