Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $462.89 / $462.89 / $462.89	Facility		$462.89	$462.89	$462.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $449.41 / $462.89 / $494.35	Professional		$449.41	$462.89	$494.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $449.41 / $449.41 / $808.93	Professional		$449.41	$449.41	$808.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $615.29 / $719.06 / $719.06	Facility		$615.29	$719.06	$719.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $648.28 / $1,185.96 / $1,680.92	Facility		$648.28	$1,185.96	$1,680.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $449.41 / $614.77 / $1,538.56	Professional		$449.41	$614.77	$1,538.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $449.41 / $471.88 / $773.69	Facility		$449.41	$471.88	$773.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $483.65 / $498.16 / $1,011.17	Facility		$483.65	$498.16	$1,011.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $483.65 / $483.65 / $1,560.53	Professional		$483.65	$483.65	$1,560.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $85.00 / $85.00	Professional		$58.40	$85.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $449.41 / $471.88 / $773.69	Facility		$449.41	$471.88	$773.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $449.41 / $699.55 / $1,999.65	Professional		$449.41	$699.55	$1,999.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $482.72 / $1,380.00 / $2,870.93	Facility		$482.72	$1,380.00	$2,870.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $449.41 / $1,173.00 / $2,709.11	Professional		$449.41	$1,173.00	$2,709.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $630.97 / $630.97 / $630.97	Professional		$630.97	$630.97	$630.97
United Facility/Professional Professional Modifier Low / Median / High Price $449.41 / $449.41 / $615.33	Professional		$449.41	$449.41	$615.33