Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,122.58 / $1,122.58 / $1,122.58	Facility		$1,122.58	$1,122.58	$1,122.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $366.62 / $366.62 / $366.62	Professional		$366.62	$366.62	$366.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,082.31 / $1,308.83 / $1,384.35	Facility		$1,082.31	$1,308.83	$1,384.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.36 / $261.32 / $2,013.60	Professional		$201.36	$261.32	$2,013.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $503.40 / $1,230.27 / $1,230.27	Facility		$503.40	$1,230.27	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,385.02 / $1,618.51 / $2,482.83	Facility		$1,385.02	$1,618.51	$2,482.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $525.00 / $656.25 / $975.59	Professional		$525.00	$656.25	$975.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $251.70 / $453.06 / $921.22	Facility		$251.70	$453.06	$921.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $503.40 / $503.40 / $503.40	Professional		$503.40	$503.40	$503.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $251.70 / $503.40 / $2,391.15	Facility		$251.70	$503.40	$2,391.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $291.97 / $503.40 / $1,057.14	Professional		$291.97	$503.40	$1,057.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $429.15	Professional		$55.00	$85.00	$429.15
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $251.70 / $453.06 / $921.22	Facility		$251.70	$453.06	$921.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $503.40 / $503.40 / $503.40	Professional		$503.40	$503.40	$503.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $591.28 / $1,198.11 / $1,711.60	Professional		$591.28	$1,198.11	$1,711.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,006.80 / $1,006.80 / $2,391.15	Facility		$1,006.80	$1,006.80	$2,391.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $266.80 / $266.80 / $266.80	Professional		$266.80	$266.80	$266.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,072.01 / $1,072.01 / $1,072.01	Professional		$1,072.01	$1,072.01	$1,072.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,462.99 / $2,748.56 / $2,748.56	Professional		$1,462.99	$2,748.56	$2,748.56
United Facility/Professional Professional Modifier Low / Median / High Price $291.97 / $402.72 / $1,335.06	Professional		$291.97	$402.72	$1,335.06