Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $542.67 / $542.67 / $542.67	Facility		$542.67	$542.67	$542.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $336.16 / $467.42 / $630.92	Professional		$336.16	$467.42	$630.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $785.90 / $1,430.34 / $1,430.34	Facility		$785.90	$1,430.34	$1,430.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $730.87 / $730.89 / $1,060.93	Professional		$730.87	$730.89	$1,060.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.41 / $498.11 / $1,681.78	Facility		$66.41	$498.11	$1,681.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $647.96 / $647.96 / $2,329.60	Facility		$647.96	$647.96	$2,329.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $550.77 / $889.50 / $1,111.88	Professional		$550.77	$889.50	$1,111.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $553.91 / $738.56 / $1,061.68	Facility		$553.91	$738.56	$1,061.68
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,107.83 / $1,107.83 / $1,107.83	Professional		$1,107.83	$1,107.83	$1,107.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $553.91 / $1,061.68 / $3,751.53	Facility		$553.91	$1,061.68	$3,751.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $334.15 / $452.45 / $995.89	Professional		$334.15	$452.45	$995.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $207.76	Professional		$50.00	$65.00	$207.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $542.67 / $814.02 / $1,061.68	Facility		$542.67	$814.02	$1,061.68
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,107.83 / $1,107.83 / $1,107.83	Professional		$1,107.83	$1,107.83	$1,107.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $103.74 / $185.37 / $240.69	Professional		$103.74	$185.37	$240.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $647.96 / $1,525.98 / $3,751.53	Facility		$647.96	$1,525.98	$3,751.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $605.17 / $647.96 / $647.96	Professional		$605.17	$647.96	$647.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $891.70 / $891.70 / $891.70	Professional		$891.70	$891.70	$891.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $891.70 / $891.70 / $891.70	Professional		$891.70	$891.70	$891.70
United Facility/Professional Professional Modifier Low / Median / High Price $295.42 / $442.37 / $947.93	Professional		$295.42	$442.37	$947.93