Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $586.39 / $732.99 / $1,089.71	Facility		$586.39	$732.99	$1,089.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $376.27 / $586.39 / $1,921.00	Professional		$376.27	$586.39	$1,921.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,050.61 / $1,270.52 / $1,343.82	Facility		$1,050.61	$1,270.52	$1,343.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.31 / $488.66 / $2,101.23	Professional		$241.31	$488.66	$2,101.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,326.92 / $1,326.92 / $1,379.09	Facility		$1,326.92	$1,326.92	$1,379.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,344.47 / $1,571.12 / $2,410.14	Facility		$1,344.47	$1,571.12	$2,410.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $561.67 / $1,315.86 / $1,495.30	Professional		$561.67	$1,315.86	$1,495.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $376.27 / $586.39 / $1,710.31	Facility		$376.27	$586.39	$1,710.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $439.79 / $586.39 / $2,082.51	Facility		$439.79	$586.39	$2,082.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $286.74 / $412.58 / $4,017.97	Professional		$286.74	$412.58	$4,017.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $1,007.52	Professional		$50.00	$85.00	$1,007.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $376.27 / $586.39 / $1,710.31	Facility		$376.27	$586.39	$1,710.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $982.15 / $1,275.44 / $1,715.89	Professional		$982.15	$1,275.44	$1,715.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,247.83 / $2,332.80 / $2,332.80	Facility		$1,247.83	$2,332.80	$2,332.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $628.79 / $2,599.34 / $4,017.97	Professional		$628.79	$2,599.34	$4,017.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,040.61 / $1,040.61 / $1,893.76	Professional		$1,040.61	$1,040.61	$1,893.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,893.76 / $1,893.76 / $2,668.08	Professional		$1,893.76	$1,893.76	$2,668.08
United Facility/Professional Professional Modifier Low / Median / High Price $244.33 / $390.93 / $1,209.69	Professional		$244.33	$390.93	$1,209.69