Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $734.91 / $734.91 / $734.91	Facility		$734.91	$734.91	$734.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $734.91 / $784.85	Professional		$713.50	$734.91	$784.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $1,212.95	Professional		$713.50	$713.50	$1,212.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $976.85 / $1,141.59 / $1,141.59	Facility		$976.85	$1,141.59	$1,141.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,726.59 / $3,158.61 / $4,476.84	Facility		$1,726.59	$3,158.61	$4,476.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $1,242.08 / $1,905.46	Professional		$713.50	$1,242.08	$1,905.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $713.50 / $749.18 / $1,124.41	Facility		$713.50	$749.18	$1,124.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $941.46 / $969.70 / $1,483.64	Facility		$941.46	$969.70	$1,483.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $941.46 / $941.46 / $1,977.07	Professional		$941.46	$941.46	$1,977.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $713.50 / $749.18 / $1,124.41	Facility		$713.50	$749.18	$1,124.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $774.08 / $3,167.99	Professional		$713.50	$774.08	$3,167.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $975.26 / $1,399.63 / $5,654.61	Facility		$975.26	$1,399.63	$5,654.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $2,356.09 / $5,654.61	Professional		$713.50	$2,356.09	$5,654.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,001.75 / $1,001.75 / $1,001.75	Professional		$1,001.75	$1,001.75	$1,001.75
United Facility/Professional Facility Modifier Low / Median / High Price $2,096.81 / $2,096.81 / $2,282.11	Facility		$2,096.81	$2,096.81	$2,282.11
United Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $927.55	Professional		$713.50	$713.50	$927.55