Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $769.29 / $1,632.92 / $2,277.92	Facility		$769.29	$1,632.92	$2,277.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $718.32 / $873.87 / $4,638.82	Professional		$718.32	$873.87	$4,638.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $867.11 / $1,331.09 / $2,701.89	Professional		$867.11	$1,331.09	$2,701.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $835.18 / $1,043.98 / $1,380.82	Facility		$835.18	$1,043.98	$1,380.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $835.18 / $978.25 / $1,723.93	Professional		$835.18	$978.25	$1,723.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,322.19 / $2,713.66 / $4,162.82	Facility		$2,322.19	$2,713.66	$4,162.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $940.07 / $2,146.96 / $3,007.03	Professional		$940.07	$2,146.96	$3,007.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $700.27 / $921.81 / $1,823.11	Facility		$700.27	$921.81	$1,823.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $700.27 / $922.58 / $1,823.11	Facility		$700.27	$922.58	$1,823.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $958.00 / $1,513.13 / $8,114.99	Professional		$958.00	$1,513.13	$8,114.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $513.78 / $1,254.99 / $1,835.26	Professional		$513.78	$1,254.99	$1,835.26
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $695.24 / $921.81 / $1,823.11	Facility		$695.24	$921.81	$1,823.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,645.75 / $2,080.07 / $2,994.58	Professional		$1,645.75	$2,080.07	$2,994.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,020.16 / $1,020.16 / $3,991.95	Facility		$1,020.16	$1,020.16	$3,991.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,075.61 / $4,485.35 / $8,114.99	Professional		$1,075.61	$4,485.35	$8,114.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,550.62 / $1,550.62 / $1,550.62	Professional		$1,550.62	$1,550.62	$1,550.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,449.00 / $2,589.44 / $2,589.44	Professional		$1,449.00	$2,589.44	$2,589.44
United Facility/Professional Professional Modifier Low / Median / High Price $937.61 / $1,467.79 / $2,691.21	Professional		$937.61	$1,467.79	$2,691.21