Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $545.79 / $1,038.53 / $1,223.29	Facility		$545.79	$1,038.53	$1,223.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $529.89 / $545.79 / $1,286.76	Professional		$529.89	$545.79	$1,286.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $662.36 / $980.30 / $1,181.65	Facility		$662.36	$980.30	$1,181.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $529.89 / $529.89 / $672.96	Professional		$529.89	$529.89	$672.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $725.46 / $725.46 / $847.82	Facility		$725.46	$725.46	$847.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $529.89 / $1,281.73 / $1,832.14	Facility		$529.89	$1,281.73	$1,832.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $534.49 / $825.02 / $937.53	Professional		$534.49	$825.02	$937.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $529.89 / $532.58 / $1,167.61	Facility		$529.89	$532.58	$1,167.61
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $798.87 / $1,059.78 / $1,059.78	Professional		$798.87	$1,059.78	$1,059.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $532.58 / $532.58 / $1,173.32	Facility		$532.58	$532.58	$1,173.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $532.58 / $532.58 / $1,059.78	Professional		$532.58	$532.58	$1,059.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $524.57	Professional		$65.00	$85.00	$524.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $529.89 / $532.58 / $1,167.61	Facility		$529.89	$532.58	$1,167.61
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $798.87 / $1,059.78 / $1,059.78	Professional		$798.87	$1,059.78	$1,059.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $529.89 / $698.85 / $1,788.60	Professional		$529.89	$698.85	$1,788.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,622.85 / $2,622.85 / $2,622.85	Facility		$2,622.85	$2,622.85	$2,622.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $529.89 / $529.89 / $529.89	Professional		$529.89	$529.89	$529.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $743.97 / $743.97 / $743.97	Professional		$743.97	$743.97	$743.97
United Facility/Professional Professional Modifier Low / Median / High Price $529.89 / $529.89 / $725.53	Professional		$529.89	$529.89	$725.53