Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $604.51 / $604.51 / $604.51	Facility		$604.51	$604.51	$604.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $572.16 / $642.95 / $832.63	Professional		$572.16	$642.95	$832.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,198.33 / $1,318.17 / $2,180.98	Facility		$1,198.33	$1,318.17	$2,180.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,078.50 / $1,114.46 / $1,473.95	Professional		$1,078.50	$1,114.46	$1,473.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $862.08 / $2,564.44 / $2,564.44	Facility		$862.08	$2,564.44	$2,564.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.69 / $2,477.46 / $5,002.04	Facility		$736.69	$2,477.46	$5,002.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.78 / $1,995.80 / $2,267.94	Professional		$537.78	$1,995.80	$2,267.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $344.78 / $906.77 / $1,378.09	Facility		$344.78	$906.77	$1,378.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $686.14 / $1,169.59 / $1,438.01	Professional		$686.14	$1,169.59	$1,438.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $596.83 / $1,198.33 / $5,580.24	Facility		$596.83	$1,198.33	$5,580.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $523.27 / $635.27 / $1,304.83	Professional		$523.27	$635.27	$1,304.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $347.99	Professional		$50.00	$70.00	$347.99
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $344.78 / $906.77 / $1,378.09	Facility		$344.78	$906.77	$1,378.09
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $686.14 / $1,169.59 / $1,438.01	Professional		$686.14	$1,169.59	$1,438.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,198.33 / $1,844.18 / $3,204.81	Professional		$1,198.33	$1,844.18	$3,204.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $736.69 / $2,340.50 / $5,580.24	Facility		$736.69	$2,340.50	$5,580.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $537.78 / $736.69 / $6,033.17	Professional		$537.78	$736.69	$6,033.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,198.33 / $1,198.33 / $1,198.33	Professional		$1,198.33	$1,198.33	$1,198.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,198.33 / $1,198.33 / $1,198.33	Professional		$1,198.33	$1,198.33	$1,198.33
United Facility/Professional Professional Modifier Low / Median / High Price $445.05 / $597.83 / $1,062.46	Professional		$445.05	$597.83	$1,062.46