Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $667.27 / $667.27 / $667.27	Facility		$667.27	$667.27	$667.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $421.37 / $600.54 / $789.26	Professional		$421.37	$600.54	$789.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,001.40 / $1,822.55 / $1,822.55	Facility		$1,001.40	$1,822.55	$1,822.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $931.30 / $931.39 / $1,351.89	Professional		$931.30	$931.39	$1,351.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.04 / $540.35 / $2,143.19	Facility		$72.04	$540.35	$2,143.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $615.17 / $615.17 / $3,058.69	Facility		$615.17	$615.17	$3,058.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $615.17 / $1,161.00 / $1,451.25	Professional		$615.17	$1,161.00	$1,451.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $274.17 / $667.27 / $1,201.08	Facility		$274.17	$667.27	$1,201.08
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $573.41 / $573.41 / $1,201.79	Professional		$573.41	$573.41	$1,201.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $274.17 / $1,201.79 / $4,704.66	Facility		$274.17	$1,201.79	$4,704.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $353.91 / $499.64 / $1,115.45	Professional		$353.91	$499.64	$1,115.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $486.86	Professional		$50.00	$65.00	$486.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $274.17 / $667.27 / $1,201.08	Facility		$274.17	$667.27	$1,201.08
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $573.41 / $573.41 / $1,201.79	Professional		$573.41	$573.41	$1,201.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $132.18 / $200.36 / $260.14	Professional		$132.18	$200.36	$260.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $615.17 / $1,956.04 / $4,704.66	Facility		$615.17	$1,956.04	$4,704.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $615.17 / $615.17 / $707.82	Professional		$615.17	$615.17	$707.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,001.49 / $1,001.49 / $1,001.49	Professional		$1,001.49	$1,001.49	$1,001.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,001.49 / $1,001.49 / $1,001.49	Professional		$1,001.49	$1,001.49	$1,001.49
United Facility/Professional Professional Modifier Low / Median / High Price $332.53 / $499.64 / $1,061.73	Professional		$332.53	$499.64	$1,061.73