Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.23 / $1,013.06 / $1,193.27	Facility		$524.23	$1,013.06	$1,193.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $508.96 / $524.23 / $1,163.54	Professional		$508.96	$524.23	$1,163.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $636.20 / $941.58 / $1,134.98	Facility		$636.20	$941.58	$1,134.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $508.96 / $508.96 / $646.37	Professional		$508.96	$508.96	$646.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $696.82 / $696.82 / $814.34	Facility		$696.82	$696.82	$814.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $508.96 / $1,193.63 / $1,706.21	Facility		$508.96	$1,193.63	$1,706.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $508.96 / $739.13 / $839.93	Professional		$508.96	$739.13	$839.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $408.04 / $519.52 / $1,121.29	Facility		$408.04	$519.52	$1,121.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $53.71 / $1,017.92 / $1,017.92	Professional		$53.71	$1,017.92	$1,017.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $408.04 / $519.52 / $1,144.81	Facility		$408.04	$519.52	$1,144.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $519.52 / $519.52 / $1,017.92	Professional		$519.52	$519.52	$1,017.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $497.70	Professional		$65.00	$85.00	$497.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $408.04 / $519.52 / $1,121.29	Facility		$408.04	$519.52	$1,121.29
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $53.71 / $1,017.92 / $1,017.92	Professional		$53.71	$1,017.92	$1,017.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $508.96 / $771.44 / $1,520.00	Professional		$508.96	$771.44	$1,520.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,488.50 / $2,488.50 / $2,488.50	Facility		$2,488.50	$2,488.50	$2,488.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $508.96 / $508.96 / $508.96	Professional		$508.96	$508.96	$508.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $555.12 / $714.58 / $731.08	Professional		$555.12	$714.58	$731.08
United Facility/Professional Professional Modifier Low / Median / High Price $508.96 / $508.96 / $763.44	Professional		$508.96	$508.96	$763.44