Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $542.08 / $542.08 / $542.08	Facility		$542.08	$542.08	$542.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $513.05 / $542.08 / $974.39	Professional		$513.05	$542.08	$974.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,074.57 / $1,182.03 / $1,955.72	Facility		$1,074.57	$1,182.03	$1,955.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $967.11 / $999.35 / $1,321.72	Professional		$967.11	$999.35	$1,321.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $773.04 / $2,299.58 / $2,299.58	Facility		$773.04	$2,299.58	$2,299.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $695.41 / $2,372.35 / $4,485.60	Facility		$695.41	$2,372.35	$4,485.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $507.65 / $1,557.19 / $2,033.70	Professional		$507.65	$1,557.19	$2,033.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $309.16 / $813.12 / $1,235.76	Facility		$309.16	$813.12	$1,235.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $615.26 / $1,048.77 / $1,289.48	Professional		$615.26	$1,048.77	$1,289.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $535.17 / $1,074.57 / $5,003.81	Facility		$535.17	$1,074.57	$5,003.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $469.22 / $562.89 / $1,170.07	Professional		$469.22	$562.89	$1,170.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $596.41	Professional		$50.00	$70.00	$596.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $309.16 / $813.12 / $1,235.76	Facility		$309.16	$813.12	$1,235.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $615.26 / $1,048.77 / $1,289.48	Professional		$615.26	$1,048.77	$1,289.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,074.57 / $1,653.72 / $2,873.59	Professional		$1,074.57	$1,653.72	$2,873.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $695.41 / $2,098.76 / $5,003.81	Facility		$695.41	$2,098.76	$5,003.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $507.65 / $695.41 / $5,409.92	Professional		$507.65	$695.41	$5,409.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,074.57 / $1,074.57 / $1,074.57	Professional		$1,074.57	$1,074.57	$1,074.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,074.57 / $1,074.57 / $1,074.57	Professional		$1,074.57	$1,074.57	$1,074.57
United Facility/Professional Professional Modifier Low / Median / High Price $374.97 / $536.09 / $1,074.57	Professional		$374.97	$536.09	$1,074.57