Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $544.42 / $1,030.73 / $1,214.08	Facility		$544.42	$1,030.73	$1,214.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $714.37 / $1,819.80	Professional		$636.59	$714.37	$1,819.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $795.74 / $1,177.69 / $1,419.60	Facility		$795.74	$1,177.69	$1,419.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $808.46	Professional		$636.59	$636.59	$808.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $871.55 / $871.55 / $1,018.54	Facility		$871.55	$871.55	$1,018.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $636.59 / $1,658.51 / $2,370.73	Facility		$636.59	$1,658.51	$2,370.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.16 / $1,114.10 / $1,266.04	Professional		$676.16	$1,114.10	$1,266.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $528.58 / $528.58 / $1,402.85	Facility		$528.58	$528.58	$1,402.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $792.87 / $1,273.18 / $1,273.18	Professional		$792.87	$1,273.18	$1,273.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $528.58 / $528.58 / $1,164.78	Facility		$528.58	$528.58	$1,164.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $528.58 / $528.58 / $1,273.18	Professional		$528.58	$528.58	$1,273.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $528.58 / $663.64	Professional		$65.00	$528.58	$663.64
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $528.58 / $528.58 / $1,402.85	Facility		$528.58	$528.58	$1,402.85
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $792.87 / $1,273.18 / $1,273.18	Professional		$792.87	$1,273.18	$1,273.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $892.38 / $1,746.00	Professional		$636.59	$892.38	$1,746.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,472.90 / $3,472.90 / $3,472.90	Facility		$3,472.90	$3,472.90	$3,472.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $636.59	Professional		$636.59	$636.59	$636.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $840.69 / $893.77 / $1,251.44	Professional		$840.69	$893.77	$1,251.44
United Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $1,018.54	Professional		$636.59	$636.59	$1,018.54