Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $520.66 / $985.75 / $1,161.08	Facility		$520.66	$985.75	$1,161.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $508.76 / $524.02 / $1,063.08	Professional		$508.76	$524.02	$1,063.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.95 / $941.21 / $1,134.53	Facility		$635.95	$941.21	$1,134.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $508.76 / $508.76 / $646.12	Professional		$508.76	$508.76	$646.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $696.54 / $696.54 / $814.02	Facility		$696.54	$696.54	$814.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $502.77 / $596.12 / $1,348.61	Facility		$502.77	$596.12	$1,348.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $502.77 / $722.07 / $820.54	Professional		$502.77	$722.07	$820.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $354.16 / $505.51 / $508.76	Facility		$354.16	$505.51	$508.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $220.18 / $1,017.52 / $1,017.52	Professional		$220.18	$1,017.52	$1,017.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $354.16 / $505.51 / $505.51	Facility		$354.16	$505.51	$505.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $505.51 / $505.51 / $1,017.52	Professional		$505.51	$505.51	$1,017.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $484.88	Professional		$65.00	$85.00	$484.88
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $354.16 / $505.51 / $508.76	Facility		$354.16	$505.51	$508.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $220.18 / $1,017.52 / $1,017.52	Professional		$220.18	$1,017.52	$1,017.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $508.76 / $672.36 / $1,499.00	Professional		$508.76	$672.36	$1,499.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,423.75 / $2,423.75 / $2,423.75	Facility		$2,423.75	$2,423.75	$2,423.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $508.76 / $508.76 / $508.76	Professional		$508.76	$508.76	$508.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $488.08 / $714.30 / $721.08	Professional		$488.08	$714.30	$721.08
United Facility/Professional Professional Modifier Low / Median / High Price $508.76 / $508.76 / $661.39	Professional		$508.76	$508.76	$661.39