Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $675.81 / $675.81 / $675.81	Facility		$675.81	$675.81	$675.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $675.81 / $721.74	Professional		$656.12	$675.81	$721.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $984.18	Professional		$656.12	$656.12	$984.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $898.29 / $1,043.23 / $1,049.79	Facility		$898.29	$1,043.23	$1,049.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $341.26 / $624.29 / $884.84	Facility		$341.26	$624.29	$884.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $958.60 / $1,311.98	Professional		$656.12	$958.60	$1,311.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $682.37 / $1,090.07	Facility		$656.12	$682.37	$1,090.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,090.07 / $1,122.77 / $1,684.16	Facility		$1,090.07	$1,122.77	$1,684.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,090.07 / $1,090.07 / $2,289.15	Professional		$1,090.07	$1,090.07	$2,289.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.00	Professional		$50.00	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $682.37 / $1,090.07	Facility		$656.12	$682.37	$1,090.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $369.61 / $656.12 / $1,021.32	Professional		$369.61	$656.12	$1,021.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,030.14 / $1,417.80 / $2,502.00	Facility		$1,030.14	$1,417.80	$2,502.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $1,768.08 / $5,838.00	Professional		$656.12	$1,768.08	$5,838.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $921.19 / $921.19 / $921.19	Professional		$921.19	$921.19	$921.19
United Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $852.96	Professional		$656.12	$656.12	$852.96