Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $496.02 / $939.06 / $1,106.11	Facility		$496.02	$939.06	$1,106.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $484.14 / $498.66 / $948.18	Professional		$484.14	$498.66	$948.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $605.17 / $895.66 / $1,079.63	Facility		$605.17	$895.66	$1,079.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $484.14 / $484.14 / $614.85	Professional		$484.14	$484.14	$614.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $662.84 / $662.84 / $774.62	Facility		$662.84	$662.84	$774.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $484.14 / $616.60 / $1,306.42	Facility		$484.14	$616.60	$1,306.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $484.14 / $691.67 / $785.99	Professional		$484.14	$691.67	$785.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $481.57 / $481.57 / $1,067.10	Facility		$481.57	$481.57	$1,067.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $722.36 / $968.28 / $968.28	Professional		$722.36	$968.28	$968.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $481.57 / $481.57 / $1,061.41	Facility		$481.57	$481.57	$1,061.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $481.57 / $481.57 / $968.28	Professional		$481.57	$481.57	$968.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $469.74	Professional		$65.00	$85.00	$469.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $481.57 / $481.57 / $1,067.10	Facility		$481.57	$481.57	$1,067.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $722.36 / $968.28 / $968.28	Professional		$722.36	$968.28	$968.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $484.13 / $513.19 / $1,597.20	Professional		$484.13	$513.19	$1,597.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,348.69 / $2,348.69 / $2,348.69	Facility		$2,348.69	$2,348.69	$2,348.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $484.14 / $484.14 / $484.14	Professional		$484.14	$484.14	$484.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $679.73 / $679.73 / $679.73	Professional		$679.73	$679.73	$679.73
United Facility/Professional Professional Modifier Low / Median / High Price $484.14 / $484.14 / $629.38	Professional		$484.14	$484.14	$629.38