Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $500.14 / $929.42 / $3,253.79	Facility		$500.14	$929.42	$3,253.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.92 / $475.51 / $2,679.90	Professional		$320.92	$475.51	$2,679.90
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 $308.73 / $403.10 / $1,792.15	Professional		$308.73	$403.10	$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 $1,146.95 / $1,340.30 / $2,056.05	Facility		$1,146.95	$1,340.30	$2,056.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.96 / $1,122.31 / $1,275.34	Professional		$478.96	$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 $320.92 / $500.14 / $1,458.73	Facility		$320.92	$500.14	$1,458.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $240.62 / $343.75 / $1,500.41	Professional		$240.62	$343.75	$1,500.41
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 / $1,087.20 / $1,416.80	Professional		$837.20	$1,087.20	$1,416.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $833.56 / $1,979.71 / $1,979.71	Facility		$833.56	$1,979.71	$1,979.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $559.38 / $2,083.90 / $2,135.73	Professional		$559.38	$2,083.90	$2,135.73
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 / $1,211.25 / $2,275.62	Professional		$428.79	$1,211.25	$2,275.62
United Facility/Professional Professional Modifier Low / Median / High Price $175.05 / $297.63 / $1,015.12	Professional		$175.05	$297.63	$1,015.12