Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $850.69 / $850.69 / $850.69	Facility		$850.69	$850.69	$850.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $805.17 / $850.69 / $1,171.71	Professional		$805.17	$850.69	$1,171.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,686.33 / $1,854.96 / $3,069.12	Facility		$1,686.33	$1,854.96	$3,069.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,502.36 / $1,568.29 / $2,074.17	Professional		$1,502.36	$1,568.29	$2,074.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,213.14 / $3,608.75 / $3,608.75	Facility		$1,213.14	$3,608.75	$3,608.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $941.33 / $3,722.81 / $7,038.41	Facility		$941.33	$3,722.81	$7,038.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $687.17 / $2,443.59 / $3,191.51	Professional		$687.17	$2,443.59	$3,191.51
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $485.19 / $1,267.53 / $1,939.28	Facility		$485.19	$1,267.53	$1,939.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $965.56 / $1,645.94 / $2,023.60	Professional		$965.56	$1,645.94	$2,023.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $839.89 / $1,686.33 / $7,852.81	Facility		$839.89	$1,686.33	$7,852.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $736.37 / $883.36 / $1,836.21	Professional		$736.37	$883.36	$1,836.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,062.42	Professional		$50.00	$70.00	$2,062.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $485.19 / $1,276.04 / $1,939.28	Facility		$485.19	$1,276.04	$1,939.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $965.56 / $1,645.94 / $2,023.60	Professional		$965.56	$1,645.94	$2,023.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,686.33 / $2,595.21 / $4,509.62	Professional		$1,686.33	$2,595.21	$4,509.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $941.33 / $3,293.62 / $7,852.81	Facility		$941.33	$3,293.62	$7,852.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $687.17 / $941.33 / $8,490.04	Professional		$687.17	$941.33	$8,490.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,686.33 / $1,686.33 / $1,686.33	Professional		$1,686.33	$1,686.33	$1,686.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,686.33 / $1,686.33 / $1,686.33	Professional		$1,686.33	$1,686.33	$1,686.33
United Facility/Professional Professional Modifier Low / Median / High Price $626.29 / $841.30 / $1,495.13	Professional		$626.29	$841.30	$1,495.13