Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $484.70 / $484.70 / $484.70	Facility		$484.70	$484.70	$484.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.43 / $440.63 / $497.89	Professional		$183.43	$440.63	$497.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $500.48 / $538.16 / $659.68	Professional		$500.48	$538.16	$659.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,238.34 / $1,238.34 / $1,238.34	Facility		$1,238.34	$1,238.34	$1,238.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,555.33 / $1,817.53 / $2,065.37	Facility		$1,555.33	$1,817.53	$2,065.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.23 / $838.59 / $1,095.19	Professional		$213.23	$838.59	$1,095.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $445.13 / $484.70 / $578.66	Facility		$445.13	$484.70	$578.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $422.64 / $496.12 / $607.60	Facility		$422.64	$496.12	$607.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $192.46 / $288.70 / $539.22	Professional		$192.46	$288.70	$539.22
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 $425.32 / $484.70 / $578.66	Facility		$425.32	$484.70	$578.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $490.25 / $868.01 / $1,290.29	Professional		$490.25	$868.01	$1,290.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,174.70 / $1,174.70 / $2,372.57	Facility		$1,174.70	$1,174.70	$2,372.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $213.23 / $2,543.00 / $2,931.93	Professional		$213.23	$2,543.00	$2,931.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $578.66 / $578.66 / $578.66	Professional		$578.66	$578.66	$578.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $440.05 / $440.05 / $578.66	Professional		$440.05	$440.05	$578.66
United Facility/Professional Professional Modifier Low / Median / High Price $173.53 / $276.64 / $459.71	Professional		$173.53	$276.64	$459.71