Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $590.79 / $590.79 / $590.79	Facility		$590.79	$590.79	$590.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $390.65 / $557.49 / $698.81	Professional		$390.65	$557.49	$698.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $886.70 / $1,613.79 / $1,613.79	Facility		$886.70	$1,613.79	$1,613.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $824.63 / $824.65 / $1,197.04	Professional		$824.63	$824.65	$1,197.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.78 / $478.42 / $1,897.58	Facility		$63.78	$478.42	$1,897.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $369.39 / $369.39 / $2,741.25	Facility		$369.39	$369.39	$2,741.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $313.98 / $1,046.63 / $1,308.28	Professional		$313.98	$1,046.63	$1,308.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $640.58 / $834.58 / $1,063.44	Facility		$640.58	$834.58	$1,063.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,064.08 / $1,064.08 / $1,064.08	Professional		$1,064.08	$1,064.08	$1,064.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $640.58 / $1,063.44 / $4,343.22	Facility		$640.58	$1,063.44	$4,343.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $409.01 / $511.27 / $1,088.55	Professional		$409.01	$511.27	$1,088.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $247.80	Professional		$50.00	$65.00	$247.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $590.79 / $886.20 / $1,063.44	Facility		$590.79	$886.20	$1,063.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,064.08 / $1,064.08 / $1,064.08	Professional		$1,064.08	$1,064.08	$1,064.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.04 / $205.88 / $267.32	Professional		$117.04	$205.88	$267.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $369.39 / $1,731.88 / $4,343.22	Facility		$369.39	$1,731.88	$4,343.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $369.39 / $369.39 / $369.39	Professional		$369.39	$369.39	$369.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $886.72 / $886.72 / $886.72	Professional		$886.72	$886.72	$886.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $886.72 / $886.72 / $886.72	Professional		$886.72	$886.72	$886.72
United Facility/Professional Professional Modifier Low / Median / High Price $362.85 / $439.21 / $886.72	Professional		$362.85	$439.21	$886.72