Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $597.36 / $1,130.98 / $1,332.18	Facility		$597.36	$1,130.98	$1,332.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $579.97 / $597.36 / $1,296.08	Professional		$579.97	$597.36	$1,296.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.96 / $1,072.93 / $1,293.31	Facility		$724.96	$1,072.93	$1,293.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $579.97 / $579.97 / $736.56	Professional		$579.97	$579.97	$736.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $794.04 / $794.04 / $927.95	Facility		$794.04	$794.04	$927.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $579.97 / $738.66 / $1,574.20	Facility		$579.97	$738.66	$1,574.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $579.97 / $841.13 / $955.83	Professional		$579.97	$841.13	$955.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $439.83 / $579.99 / $1,278.10	Facility		$439.83	$579.99	$1,278.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $869.99 / $1,159.94 / $1,159.94	Professional		$869.99	$1,159.94	$1,159.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $439.83 / $579.99 / $1,278.10	Facility		$439.83	$579.99	$1,278.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $579.99 / $579.99 / $1,159.94	Professional		$579.99	$579.99	$1,159.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $564.64	Professional		$65.00	$85.00	$564.64
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $439.83 / $579.99 / $1,278.10	Facility		$439.83	$579.99	$1,278.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $869.99 / $1,159.94 / $1,159.94	Professional		$869.99	$1,159.94	$1,159.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $579.97 / $798.98 / $1,741.00	Professional		$579.97	$798.98	$1,741.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,823.20 / $2,823.20 / $2,823.20	Facility		$2,823.20	$2,823.20	$2,823.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $579.97 / $579.97 / $579.97	Professional		$579.97	$579.97	$579.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $598.29 / $814.28 / $837.33	Professional		$598.29	$814.28	$837.33
United Facility/Professional Professional Modifier Low / Median / High Price $579.97 / $579.97 / $753.96	Professional		$579.97	$579.97	$753.96