Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.21 / $1,089.19 / $1,282.96	Facility		$575.21	$1,089.19	$1,282.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $558.46 / $575.21 / $1,422.45	Professional		$558.46	$575.21	$1,422.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $698.08 / $1,033.15 / $1,245.36	Facility		$698.08	$1,033.15	$1,245.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $558.46 / $558.46 / $709.24	Professional		$558.46	$558.46	$709.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $764.59 / $764.59 / $893.54	Facility		$764.59	$764.59	$893.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $557.92 / $654.34 / $1,496.58	Facility		$557.92	$654.34	$1,496.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $557.92 / $846.73 / $962.19	Professional		$557.92	$846.73	$962.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $475.87 / $558.46 / $558.55	Facility		$475.87	$558.46	$558.55
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $319.33 / $1,116.92 / $1,116.92	Professional		$319.33	$1,116.92	$1,116.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $475.87 / $558.55 / $558.55	Facility		$475.87	$558.55	$558.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $558.55 / $558.55 / $1,116.92	Professional		$558.55	$558.55	$1,116.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $542.57	Professional		$65.00	$85.00	$542.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $475.87 / $558.46 / $558.55	Facility		$475.87	$558.46	$558.55
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $319.33 / $1,116.92 / $1,116.92	Professional		$319.33	$1,116.92	$1,116.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $558.46 / $840.99 / $1,676.00	Professional		$558.46	$840.99	$1,676.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $558.46 / $558.46 / $2,714.60	Facility		$558.46	$558.46	$2,714.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $558.46 / $558.46 / $558.46	Professional		$558.46	$558.46	$558.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $678.65 / $784.08 / $858.70	Professional		$678.65	$784.08	$858.70
United Facility/Professional Professional Modifier Low / Median / High Price $558.46 / $558.46 / $764.64	Professional		$558.46	$558.46	$764.64