Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $545.26 / $1,032.29 / $1,215.93	Facility		$545.26	$1,032.29	$1,215.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $546.29 / $568.36 / $1,745.57	Professional		$546.29	$568.36	$1,745.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $682.86 / $1,010.64 / $1,218.23	Facility		$682.86	$1,010.64	$1,218.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $546.29 / $546.29 / $693.78	Professional		$546.29	$546.29	$693.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $747.92 / $747.92 / $874.06	Facility		$747.92	$747.92	$874.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $546.29 / $1,281.82 / $1,832.27	Facility		$546.29	$1,281.82	$1,832.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $546.29 / $864.30 / $982.16	Professional		$546.29	$864.30	$982.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $480.24 / $529.38 / $1,203.98	Facility		$480.24	$529.38	$1,203.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $533.90 / $1,092.58 / $1,092.58	Professional		$533.90	$1,092.58	$1,092.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $480.24 / $529.38 / $1,166.91	Facility		$480.24	$529.38	$1,166.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $529.38 / $529.38 / $1,092.58	Professional		$529.38	$529.38	$1,092.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $521.83	Professional		$65.00	$85.00	$521.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $480.24 / $529.38 / $1,203.98	Facility		$480.24	$529.38	$1,203.98
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $533.90 / $1,092.58 / $1,092.58	Professional		$533.90	$1,092.58	$1,092.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $546.29 / $579.07 / $1,024.09	Professional		$546.29	$579.07	$1,024.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,331.25 / $3,331.25 / $3,331.25	Facility		$3,331.25	$3,331.25	$3,331.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $546.29 / $546.29 / $546.29	Professional		$546.29	$546.29	$546.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $555.41 / $766.99 / $878.00	Professional		$555.41	$766.99	$878.00
United Facility/Professional Professional Modifier Low / Median / High Price $546.29 / $546.29 / $1,037.23	Professional		$546.29	$546.29	$1,037.23