Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $610.14 / $610.14 / $610.14	Facility		$610.14	$610.14	$610.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $577.50 / $610.14 / $1,096.76	Professional		$577.50	$610.14	$1,096.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,209.49 / $1,330.44 / $2,201.27	Facility		$1,209.49	$1,330.44	$2,201.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,124.83 / $1,124.83 / $1,487.67	Professional		$1,124.83	$1,124.83	$1,487.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $870.10 / $2,588.31 / $2,588.31	Facility		$870.10	$2,588.31	$2,588.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $782.41 / $2,670.90 / $5,048.22	Facility		$782.41	$2,670.90	$5,048.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $571.16 / $1,752.66 / $2,289.05	Professional		$571.16	$1,752.66	$2,289.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $347.99 / $915.21 / $1,390.91	Facility		$347.99	$915.21	$1,390.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $692.53 / $1,180.47 / $1,451.39	Professional		$692.53	$1,180.47	$1,451.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $602.38 / $1,209.49 / $5,632.19	Facility		$602.38	$1,209.49	$5,632.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $528.14 / $633.57 / $1,316.98	Professional		$528.14	$633.57	$1,316.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,239.64	Professional		$50.00	$70.00	$1,239.64
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $347.99 / $915.21 / $1,390.91	Facility		$347.99	$915.21	$1,390.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $692.53 / $1,180.47 / $1,451.39	Professional		$692.53	$1,180.47	$1,451.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,209.49 / $1,861.36 / $3,233.92	Professional		$1,209.49	$1,861.36	$3,233.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $782.41 / $2,362.28 / $5,632.19	Facility		$782.41	$2,362.28	$5,632.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $571.16 / $782.41 / $6,089.34	Professional		$571.16	$782.41	$6,089.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,209.49 / $1,209.49 / $1,209.49	Professional		$1,209.49	$1,209.49	$1,209.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,209.49 / $1,209.49 / $1,209.49	Professional		$1,209.49	$1,209.49	$1,209.49
United Facility/Professional Professional Modifier Low / Median / High Price $422.06 / $603.40 / $1,156.52	Professional		$422.06	$603.40	$1,156.52