Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,084.47 / $1,084.47 / $1,084.47	Facility		$1,084.47	$1,084.47	$1,084.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,052.89 / $1,084.47 / $1,158.18	Professional		$1,052.89	$1,084.47	$1,158.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,052.89 / $1,052.89 / $1,579.33	Professional		$1,052.89	$1,052.89	$1,579.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,441.51 / $1,684.62 / $1,684.62	Facility		$1,441.51	$1,684.62	$1,684.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $401.75 / $734.95 / $1,052.89	Facility		$401.75	$734.95	$1,052.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.02 / $366.40 / $1,052.89	Professional		$315.02	$366.40	$1,052.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $871.37 / $1,084.47 / $1,659.24	Facility		$871.37	$1,084.47	$1,659.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $871.37 / $897.51 / $1,346.27	Facility		$871.37	$897.51	$1,346.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $871.37 / $871.37 / $1,325.33	Professional		$871.37	$871.37	$1,325.33
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 $871.37 / $1,084.47 / $1,659.24	Facility		$871.37	$1,084.47	$1,659.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $398.85 / $1,052.89 / $1,116.06	Professional		$398.85	$1,052.89	$1,116.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $300.18 / $848.30 / $1,325.33	Facility		$300.18	$848.30	$1,325.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $424.79 / $1,052.89 / $1,325.33	Professional		$424.79	$1,052.89	$1,325.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,478.26 / $1,478.26 / $1,478.26	Professional		$1,478.26	$1,478.26	$1,478.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,052.89 / $1,052.89 / $1,263.47	Professional		$1,052.89	$1,052.89	$1,263.47