Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $475.20 / $475.20 / $475.20	Facility		$475.20	$475.20	$475.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $461.36 / $475.20 / $507.49	Professional		$461.36	$475.20	$507.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $461.36 / $461.36 / $692.04	Professional		$461.36	$461.36	$692.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $631.65 / $738.18 / $738.18	Facility		$631.65	$738.18	$738.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,253.27 / $2,292.71 / $3,249.58	Facility		$1,253.27	$2,292.71	$3,249.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.35 / $461.36 / $638.77	Professional		$165.35	$461.36	$638.77
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $330.31 / $475.20 / $727.06	Facility		$330.31	$475.20	$727.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $330.31 / $340.22 / $612.40	Facility		$330.31	$340.22	$612.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $330.31 / $330.31 / $1,667.22	Professional		$330.31	$330.31	$1,667.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.00 / $85.00	Professional		$50.00	$60.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $330.31 / $475.20 / $727.06	Facility		$330.31	$475.20	$727.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $461.35 / $461.36 / $1,275.91	Professional		$461.35	$461.36	$1,275.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $501.55 / $1,417.80 / $3,171.34	Facility		$501.55	$1,417.80	$3,171.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $461.36 / $1,280.97 / $3,610.00	Professional		$461.36	$1,280.97	$3,610.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $647.75 / $647.75 / $647.75	Professional		$647.75	$647.75	$647.75
United Facility/Professional Professional Modifier Low / Median / High Price $461.36 / $461.36 / $599.77	Professional		$461.36	$461.36	$599.77