Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $500.14 / $820.35 / $1,751.85	Facility		$500.14	$820.35	$1,751.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $333.42 / $500.14 / $1,475.00	Professional		$333.42	$500.14	$1,475.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $896.08 / $1,083.63 / $1,146.15	Facility		$896.08	$1,083.63	$1,146.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.82 / $416.78 / $1,792.15	Professional		$205.82	$416.78	$1,792.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $619.02 / $1,176.25	Facility		$416.78	$619.02	$1,176.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $437.62 / $538.70	Professional		$416.78	$437.62	$538.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,147.13 / $1,340.51 / $2,056.37	Facility		$1,147.13	$1,340.51	$2,056.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.67 / $1,122.31 / $1,275.34	Professional		$478.67	$1,122.31	$1,275.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $320.92 / $500.14 / $1,458.73	Facility		$320.92	$500.14	$1,458.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $458.46 / $763.21 / $1,458.73	Facility		$458.46	$763.21	$1,458.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $249.24 / $416.78 / $1,397.09	Professional		$249.24	$416.78	$1,397.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $416.78	Professional		$50.00	$70.00	$416.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $320.92 / $500.14 / $1,458.73	Facility		$320.92	$500.14	$1,458.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $837.20 / $1,085.61 / $1,416.80	Professional		$837.20	$1,085.61	$1,416.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $894.54 / $1,979.71 / $1,979.71	Facility		$894.54	$1,979.71	$1,979.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $526.83 / $2,083.90 / $2,083.90	Professional		$526.83	$2,083.90	$2,083.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $428.79 / $428.79 / $887.55	Professional		$428.79	$428.79	$887.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $428.79 / $428.79 / $2,275.62	Professional		$428.79	$428.79	$2,275.62
United Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $340.31 / $1,770.65	Professional		$95.00	$340.31	$1,770.65