Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $768.88 / $768.88 / $1,428.83	Facility		$768.88	$768.88	$1,428.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $525.40 / $602.29 / $768.88	Professional		$525.40	$602.29	$768.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.00 / $208.00 / $2,562.92	Professional		$208.00	$208.00	$2,562.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $640.73 / $640.73 / $1,627.45	Facility		$640.73	$640.73	$1,627.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,763.49 / $2,060.78 / $3,161.29	Facility		$1,763.49	$2,060.78	$3,161.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $736.38 / $1,725.36 / $1,960.64	Professional		$736.38	$1,725.36	$1,960.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $384.44 / $384.44 / $768.88	Facility		$384.44	$384.44	$768.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $384.44 / $512.58 / $3,043.47	Facility		$384.44	$512.58	$3,043.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $371.62 / $640.73 / $1,345.53	Professional		$371.62	$640.73	$1,345.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $640.73 / $1,768.41	Professional		$85.00	$640.73	$1,768.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $384.44 / $384.44 / $768.88	Facility		$384.44	$384.44	$768.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $851.43 / $1,527.95 / $2,179.10	Professional		$851.43	$1,527.95	$2,179.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,281.46 / $1,281.46 / $3,043.47	Facility		$1,281.46	$1,281.46	$3,043.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $311.70 / $311.70 / $311.70	Professional		$311.70	$311.70	$311.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,364.75 / $1,364.75 / $1,364.75	Professional		$1,364.75	$1,364.75	$1,364.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,498.39 / $3,498.39 / $3,498.39	Professional		$3,498.39	$3,498.39	$3,498.39
United Facility/Professional Professional Modifier Low / Median / High Price $371.62 / $512.58 / $1,699.27	Professional		$371.62	$512.58	$1,699.27