Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $594.36 / $1,125.25 / $1,325.42	Facility		$594.36	$1,125.25	$1,325.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $593.00 / $610.79 / $1,248.60	Professional		$593.00	$610.79	$1,248.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.25 / $1,097.05 / $1,322.39	Facility		$741.25	$1,097.05	$1,322.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $593.00 / $593.00 / $753.11	Professional		$593.00	$593.00	$753.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $811.87 / $811.87 / $948.80	Facility		$811.87	$811.87	$948.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $593.00 / $1,412.36 / $2,018.87	Facility		$593.00	$1,412.36	$2,018.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $586.61 / $902.39 / $1,025.44	Professional		$586.61	$902.39	$1,025.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $384.85 / $577.04 / $1,306.61	Facility		$384.85	$577.04	$1,306.61
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $71.08 / $1,186.00 / $1,186.00	Professional		$71.08	$1,186.00	$1,186.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $384.85 / $577.04 / $1,382.49	Facility		$384.85	$577.04	$1,382.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $577.04 / $577.04 / $1,186.00	Professional		$577.04	$577.04	$1,186.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $575.76	Professional		$65.00	$85.00	$575.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $384.85 / $577.04 / $1,306.61	Facility		$384.85	$577.04	$1,306.61
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $71.08 / $1,186.00 / $1,186.00	Professional		$71.08	$1,186.00	$1,186.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $593.00 / $858.14 / $1,769.00	Professional		$593.00	$858.14	$1,769.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $593.00 / $593.00 / $2,878.80	Facility		$593.00	$593.00	$2,878.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $593.00 / $593.00 / $593.00	Professional		$593.00	$593.00	$593.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $523.26 / $832.57 / $850.67	Professional		$523.26	$832.57	$850.67
United Facility/Professional Professional Modifier Low / Median / High Price $593.00 / $593.00 / $811.94	Professional		$593.00	$593.00	$811.94