Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $511.40 / $968.20 / $1,140.42	Facility		$511.40	$968.20	$1,140.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $511.64 / $853.00	Professional		$496.74	$511.64	$853.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $620.92 / $918.97 / $1,107.73	Facility		$620.92	$918.97	$1,107.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $496.74 / $630.85	Professional		$496.74	$496.74	$630.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $680.09 / $680.09 / $794.78	Facility		$680.09	$680.09	$794.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $496.74 / $632.63 / $1,367.14	Facility		$496.74	$632.63	$1,367.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $506.06 / $766.38 / $870.89	Professional		$506.06	$766.38	$870.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $496.51 / $496.51 / $1,094.91	Facility		$496.51	$496.51	$1,094.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $744.77 / $993.48 / $993.48	Professional		$744.77	$993.48	$993.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $496.50 / $496.51 / $1,094.20	Facility		$496.50	$496.51	$1,094.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $496.51 / $556.09 / $993.48	Professional		$496.51	$556.09	$993.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $496.68	Professional		$85.00	$85.00	$496.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $496.51 / $496.51 / $1,094.91	Facility		$496.51	$496.51	$1,094.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $744.77 / $993.48 / $993.48	Professional		$744.77	$993.48	$993.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $538.91 / $1,683.00	Professional		$496.74	$538.91	$1,683.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,483.40 / $2,483.40 / $2,483.40	Facility		$2,483.40	$2,483.40	$2,483.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $496.74 / $496.74	Professional		$496.74	$496.74	$496.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $496.51 / $496.51 / $496.51	Professional		$496.51	$496.51	$496.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $697.42 / $697.42 / $697.42	Professional		$697.42	$697.42	$697.42
United Facility/Professional Professional Modifier Low / Median / High Price $496.74 / $556.35 / $625.89	Professional		$496.74	$556.35	$625.89