Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $683.53 / $683.53 / $683.53	Facility		$683.53	$683.53	$683.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $683.53 / $729.99	Professional		$663.63	$683.53	$729.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $1,128.17	Professional		$663.63	$663.63	$1,128.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $908.57 / $982.17 / $1,061.81	Facility		$908.57	$982.17	$1,061.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,152.29 / $2,107.98 / $2,987.75	Facility		$1,152.29	$2,107.98	$2,987.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $688.67 / $930.83	Professional		$663.63	$688.67	$930.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $663.63 / $696.81 / $1,045.80	Facility		$663.63	$696.81	$1,045.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $717.78 / $739.31 / $1,131.14	Facility		$717.78	$739.31	$1,131.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $717.78 / $717.78 / $1,507.34	Professional		$717.78	$717.78	$1,507.34
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 $663.63 / $696.81 / $1,045.80	Facility		$663.63	$696.81	$1,045.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $663.62 / $719.97 / $2,124.53	Professional		$663.62	$719.97	$2,124.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $719.37 / $956.90 / $3,792.20	Facility		$719.37	$956.90	$3,792.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $1,580.09 / $3,800.00	Professional		$663.63	$1,580.09	$3,800.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $931.74 / $931.74 / $931.74	Professional		$931.74	$931.74	$931.74
United Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $862.72	Professional		$663.63	$663.63	$862.72