Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $918.07 / $918.07 / $918.07	Facility		$918.07	$918.07	$918.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $761.82 / $918.07 / $1,446.83	Professional		$761.82	$918.07	$1,446.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.89 / $2,001.88 / $3,312.20	Facility		$1,819.89	$2,001.88	$3,312.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,637.90 / $1,692.50 / $2,238.46	Professional		$1,637.90	$1,692.50	$2,238.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,309.22 / $3,894.56 / $3,894.56	Facility		$1,309.22	$3,894.56	$3,894.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,025.33 / $4,018.37 / $7,596.83	Facility		$1,025.33	$4,018.37	$7,596.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $748.49 / $2,637.19 / $3,444.29	Professional		$748.49	$2,637.19	$3,444.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $516.66 / $1,377.11 / $2,092.87	Facility		$516.66	$1,377.11	$2,092.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,042.02 / $1,819.89 / $2,183.87	Professional		$1,042.02	$1,819.89	$2,183.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $894.38 / $1,819.89 / $8,501.27	Facility		$894.38	$1,819.89	$8,501.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $739.96 / $958.33 / $1,981.64	Professional		$739.96	$958.33	$1,981.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,228.15	Professional		$50.00	$70.00	$1,228.15
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $516.66 / $1,377.11 / $2,092.87	Facility		$516.66	$1,377.11	$2,092.87
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,042.02 / $1,819.89 / $2,183.87	Professional		$1,042.02	$1,819.89	$2,183.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,819.89 / $2,800.73 / $4,801.70	Professional		$1,819.89	$2,800.73	$4,801.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,025.33 / $3,554.48 / $8,501.27	Facility		$1,025.33	$3,554.48	$8,501.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $748.49 / $1,025.33 / $9,927.28	Professional		$748.49	$1,025.33	$9,927.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.89 / $1,819.89 / $1,819.89	Professional		$1,819.89	$1,819.89	$1,819.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.89 / $1,819.89 / $1,819.89	Professional		$1,819.89	$1,819.89	$1,819.89
United Facility/Professional Professional Modifier Low / Median / High Price $666.93 / $907.92 / $1,819.89	Professional		$666.93	$907.92	$1,819.89