Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,363.05 / $2,753.58 / $3,162.34	Facility		$1,363.05	$2,753.58	$3,162.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,363.05 / $1,588.01	Professional		$1,323.35	$1,363.05	$1,588.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,654.19 / $2,448.19 / $2,951.07	Facility		$1,654.19	$2,448.19	$2,951.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,786.52	Professional		$1,323.35	$1,323.35	$1,786.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,117.36 / $2,382.03 / $2,425.57	Facility		$2,117.36	$2,382.03	$2,425.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,323.35 / $2,002.65 / $3,998.21	Facility		$1,323.35	$2,002.65	$3,998.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,733.46 / $2,677.93	Professional		$1,323.35	$1,733.46	$2,677.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,223.45 / $1,363.05 / $1,611.22	Facility		$1,223.45	$1,363.05	$1,611.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $299.29 / $2,646.70 / $2,646.70	Professional		$299.29	$2,646.70	$2,646.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,223.45 / $1,376.79 / $1,720.98	Facility		$1,223.45	$1,376.79	$1,720.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,376.79 / $1,532.66 / $6,148.12	Professional		$1,376.79	$1,532.66	$6,148.12
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 $1,223.45 / $1,363.05 / $1,654.18	Facility		$1,223.45	$1,363.05	$1,654.18
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $299.29 / $2,646.70 / $2,646.70	Professional		$299.29	$2,646.70	$2,646.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $2,059.92 / $4,305.00	Professional		$1,323.35	$2,059.92	$4,305.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,323.35 / $1,444.55 / $7,222.75	Facility		$1,323.35	$1,444.55	$7,222.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $2,561.71 / $6,148.12	Professional		$1,323.35	$2,561.71	$6,148.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,663.90 / $1,857.98 / $2,251.04	Professional		$1,663.90	$1,857.98	$2,251.04
United Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,349.82 / $1,667.42	Professional		$1,323.35	$1,349.82	$1,667.42