Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $512.73 / $970.71 / $1,143.39	Facility		$512.73	$970.71	$1,143.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $498.14 / $513.08 / $1,286.08	Professional		$498.14	$513.08	$1,286.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $622.67 / $921.54 / $1,110.83	Facility		$622.67	$921.54	$1,110.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $498.14 / $498.14 / $632.63	Professional		$498.14	$498.14	$632.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $682.00 / $682.00 / $797.02	Facility		$682.00	$682.00	$797.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $498.14 / $1,202.56 / $1,718.98	Facility		$498.14	$1,202.56	$1,718.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $500.03 / $765.68 / $870.09	Professional		$500.03	$765.68	$870.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $450.76 / $497.80 / $1,097.77	Facility		$450.76	$497.80	$1,097.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $746.70 / $996.28 / $996.28	Professional		$746.70	$996.28	$996.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $450.76 / $497.80 / $1,097.06	Facility		$450.76	$497.80	$1,097.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $497.80 / $497.80 / $996.28	Professional		$497.80	$497.80	$996.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $490.77	Professional		$65.00	$85.00	$490.77
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $450.76 / $497.80 / $1,097.77	Facility		$450.76	$497.80	$1,097.77
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $746.70 / $996.28 / $996.28	Professional		$746.70	$996.28	$996.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $498.14 / $760.69 / $1,526.00	Professional		$498.14	$760.69	$1,526.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,454.35 / $2,454.35 / $2,454.35	Facility		$2,454.35	$2,454.35	$2,454.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $498.14 / $498.14 / $498.14	Professional		$498.14	$498.14	$498.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $613.33 / $699.39 / $776.05	Professional		$613.33	$699.39	$776.05
United Facility/Professional Professional Modifier Low / Median / High Price $498.14 / $498.14 / $747.21	Professional		$498.14	$498.14	$747.21