Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.96 / $509.64 / $780.41	Facility		$349.96	$509.64	$780.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $340.31 / $350.52 / $583.71	Professional		$340.31	$350.52	$583.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $425.39 / $425.39 / $758.89	Facility		$425.39	$425.39	$758.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.31 / $340.31 / $510.46	Professional		$340.31	$340.31	$510.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $465.91 / $503.66 / $544.50	Facility		$465.91	$503.66	$544.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $340.31 / $809.60 / $1,157.27	Facility		$340.31	$809.60	$1,157.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.46 / $466.39 / $529.99	Professional		$346.46	$466.39	$529.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $339.76 / $340.31 / $749.90	Facility		$339.76	$340.31	$749.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $509.64 / $680.62 / $13,572.56	Professional		$509.64	$680.62	$13,572.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $339.76 / $437.45 / $29,984.75	Facility		$339.76	$437.45	$29,984.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $254.82 / $339.76 / $465.20	Professional		$254.82	$339.76	$465.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $340.04	Professional		$50.00	$65.00	$340.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $339.76 / $340.31 / $749.90	Facility		$339.76	$340.31	$749.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $509.64 / $680.62 / $13,572.56	Professional		$509.64	$680.62	$13,572.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $340.31 / $403.97 / $1,169.67	Professional		$340.31	$403.97	$1,169.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $18,615.00 / $18,615.00 / $29,984.75	Facility		$18,615.00	$18,615.00	$29,984.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $328.91 / $340.31 / $340.31	Professional		$328.91	$340.31	$340.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $477.80 / $477.80 / $25,177.96	Professional		$477.80	$477.80	$25,177.96
United Facility/Professional Professional Modifier Low / Median / High Price $289.26 / $340.31 / $408.37	Professional		$289.26	$340.31	$408.37