Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $674.96 / $674.96 / $674.96	Facility		$674.96	$674.96	$674.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $674.96 / $720.83	Professional		$655.29	$674.96	$720.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $1,179.54	Professional		$655.29	$655.29	$1,179.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $897.16 / $969.84 / $1,048.48	Facility		$897.16	$969.84	$1,048.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,690.29 / $3,092.19 / $4,382.71	Facility		$1,690.29	$3,092.19	$4,382.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $1,197.38 / $2,723.95	Professional		$655.29	$1,197.38	$2,723.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $655.29 / $681.51 / $1,032.69	Facility		$655.29	$681.51	$1,032.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $730.43 / $752.34 / $1,354.21	Facility		$730.43	$752.34	$1,354.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $730.43 / $730.43 / $1,749.83	Professional		$730.43	$730.43	$1,749.83
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 $655.29 / $681.51 / $1,032.69	Facility		$655.29	$681.51	$1,032.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $1,020.05 / $3,534.34	Professional		$655.29	$1,020.05	$3,534.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $940.15 / $1,537.00 / $5,146.99	Facility		$940.15	$1,537.00	$5,146.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $1,869.62 / $5,727.50	Professional		$655.29	$1,869.62	$5,727.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $920.04 / $920.04 / $920.04	Professional		$920.04	$920.04	$920.04
United Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $851.89	Professional		$655.29	$655.29	$851.89