Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $725.83 / $725.83 / $725.83	Facility		$725.83	$725.83	$725.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $466.67 / $658.54 / $875.88	Professional		$466.67	$658.54	$875.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,002.70 / $1,102.97 / $1,824.91	Facility		$1,002.70	$1,102.97	$1,824.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $692.28 / $932.51 / $1,233.32	Professional		$692.28	$932.51	$1,233.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.69 / $214.58 / $214.58	Facility		$70.69	$214.58	$214.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $546.85 / $3,082.24 / $4,862.28	Facility		$546.85	$3,082.24	$4,862.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $546.85 / $1,177.50 / $1,471.88	Professional		$546.85	$1,177.50	$1,471.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $77.84 / $437.85 / $1,088.75	Facility		$77.84	$437.85	$1,088.75
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $91.58 / $91.58 / $120.32	Professional		$91.58	$91.58	$120.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $1,013.94 / $5,046.28	Facility		$80.00	$1,013.94	$5,046.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.96 / $114.47 / $893.16	Professional		$53.96	$114.47	$893.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.67 / $58.40 / $685.84	Professional		$1.67	$58.40	$685.84
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $77.84 / $437.85 / $1,129.65	Facility		$77.84	$437.85	$1,129.65
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $91.58 / $91.58 / $120.32	Professional		$91.58	$91.58	$120.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $111.95 / $224.81 / $291.89	Professional		$111.95	$224.81	$291.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $1,713.86 / $5,046.28	Facility		$65.00	$1,713.86	$5,046.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.44 / $546.85 / $739.60	Professional		$81.44	$546.85	$739.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,155.79 / $1,359.75 / $1,359.75	Professional		$1,155.79	$1,359.75	$1,359.75
United Facility/Professional Professional Modifier Low / Median / High Price $53.96 / $114.47 / $880.60	Professional		$53.96	$114.47	$880.60