Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $850.08 / $850.08 / $850.08	Facility		$850.08	$850.08	$850.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $850.08 / $850.08 / $1,062.59	Professional		$850.08	$850.08	$1,062.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,323.29 / $1,537.87 / $1,595.10	Facility		$1,323.29	$1,537.87	$1,595.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.04 / $758.52 / $885.50	Professional		$186.04	$758.52	$885.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.12 / $584.42 / $903.21	Facility		$500.12	$584.42	$903.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $903.21 / $1,639.61 / $1,863.19	Professional		$903.21	$1,639.61	$1,863.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $181.50 / $850.08 / $1,211.35	Facility		$181.50	$850.08	$1,211.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $148.58 / $148.58 / $148.58	Professional		$148.58	$148.58	$148.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $181.50 / $850.08 / $1,211.35	Facility		$181.50	$850.08	$1,211.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $885.50 / $885.50 / $1,416.80	Professional		$885.50	$885.50	$1,416.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $3,183.76	Professional		$55.00	$85.00	$3,183.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $181.50 / $850.08 / $1,211.35	Facility		$181.50	$850.08	$1,211.35
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $148.58 / $148.58 / $148.58	Professional		$148.58	$148.58	$148.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $202.76 / $422.67 / $622.30	Professional		$202.76	$422.67	$622.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,795.00 / $3,795.00 / $3,795.00	Facility		$3,795.00	$3,795.00	$3,795.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $903.21 / $1,126.35 / $3,845.60	Professional		$903.21	$1,126.35	$3,845.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,112.74 / $1,112.74 / $1,112.74	Professional		$1,112.74	$1,112.74	$1,112.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,501.08 / $3,445.04 / $3,445.04	Professional		$1,501.08	$3,445.04	$3,445.04
United Facility/Professional Professional Modifier Low / Median / High Price $885.50 / $885.50 / $1,151.15	Professional		$885.50	$885.50	$1,151.15