Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $692.09 / $692.09 / $692.09	Facility		$692.09	$692.09	$692.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $437.08 / $622.88 / $818.64	Professional		$437.08	$622.88	$818.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,038.70 / $1,890.43 / $1,890.43	Facility		$1,038.70	$1,890.43	$1,890.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $835.16 / $965.99 / $1,448.98	Professional		$835.16	$965.99	$1,448.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.73 / $74.73 / $222.28	Facility		$74.73	$74.73	$222.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,355.54 / $2,355.54 / $3,174.40	Facility		$2,355.54	$2,355.54	$3,174.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,203.75 / $1,504.69 / $2,355.54	Professional		$1,203.75	$1,504.69	$2,355.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.67 / $119.45 / $1,038.14	Facility		$64.67	$119.45	$1,038.14
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $124.64 / $124.64 / $124.64	Professional		$124.64	$124.64	$124.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.10 / $1,038.14 / $4,660.41	Facility		$83.10	$1,038.14	$4,660.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $364.33 / $498.05 / $865.24	Professional		$364.33	$498.05	$865.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $1.98 / $55.00 / $810.73	Professional		$1.98	$55.00	$810.73
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.67 / $119.45 / $1,038.14	Facility		$64.67	$119.45	$1,038.14
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $124.64 / $124.64 / $124.64	Professional		$124.64	$124.64	$124.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $116.66 / $207.45 / $269.36	Professional		$116.66	$207.45	$269.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,654.57 / $1,677.54 / $4,660.41	Facility		$1,654.57	$1,677.54	$4,660.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $2,355.54 / $2,355.54	Professional		$73.42	$2,355.54	$2,355.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,838.15 / $3,339.00 / $3,339.00	Professional		$2,838.15	$3,339.00	$3,339.00
United Facility/Professional Professional Modifier Low / Median / High Price $350.58 / $464.85 / $865.24	Professional		$350.58	$464.85	$865.24