Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $592.77 / $1,212.70 / $1,392.72	Facility		$592.77	$1,212.70	$1,392.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $592.77 / $734.90	Professional		$575.50	$592.77	$734.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $719.38 / $1,064.68 / $1,283.36	Facility		$719.38	$1,064.68	$1,283.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $575.50 / $776.92	Professional		$575.50	$575.50	$776.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $851.74 / $920.80 / $1,054.83	Facility		$851.74	$920.80	$1,054.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.50 / $1,359.25 / $2,357.96	Facility		$575.50	$1,359.25	$2,357.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $683.50 / $1,230.26	Professional		$575.50	$683.50	$1,230.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $486.53 / $592.77 / $633.04	Facility		$486.53	$592.77	$633.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $909.53 / $1,151.00 / $1,151.00	Professional		$909.53	$1,151.00	$1,151.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $486.53 / $606.35 / $668.45	Facility		$486.53	$606.35	$668.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $606.35 / $674.99 / $2,905.58	Professional		$606.35	$674.99	$2,905.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $486.53 / $592.77 / $633.04	Facility		$486.53	$592.77	$633.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $909.53 / $1,151.00 / $1,151.00	Professional		$909.53	$1,151.00	$1,151.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $874.64 / $2,238.50	Professional		$575.50	$874.64	$2,238.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $575.50 / $708.35 / $3,478.85	Facility		$575.50	$708.35	$3,478.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $1,210.66 / $2,905.58	Professional		$575.50	$1,210.66	$2,905.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $661.90 / $808.00 / $808.00	Professional		$661.90	$808.00	$808.00
United Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $592.82 / $684.85	Professional		$575.50	$592.82	$684.85