Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $623.95 / $623.95 / $623.95	Facility		$623.95	$623.95	$623.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $590.57 / $663.79 / $962.50	Professional		$590.57	$663.79	$962.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,236.85 / $1,360.55 / $2,251.09	Facility		$1,236.85	$1,360.55	$2,251.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,113.17 / $1,150.28 / $1,521.33	Professional		$1,113.17	$1,150.28	$1,521.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $889.80 / $2,646.88 / $2,646.88	Facility		$889.80	$2,646.88	$2,646.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $756.07 / $2,731.00 / $5,162.99	Facility		$756.07	$2,731.00	$5,162.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $551.92 / $1,792.50 / $2,340.85	Professional		$551.92	$1,792.50	$2,340.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $355.96 / $935.93 / $1,422.39	Facility		$355.96	$935.93	$1,422.39
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $708.20 / $1,207.24 / $1,484.23	Professional		$708.20	$1,207.24	$1,484.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $616.17 / $1,353.92 / $5,761.13	Facility		$616.17	$1,353.92	$5,761.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $540.10 / $655.87 / $1,346.79	Professional		$540.10	$655.87	$1,346.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $834.70	Professional		$50.00	$65.00	$834.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $355.96 / $935.93 / $1,422.39	Facility		$355.96	$935.93	$1,422.39
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $708.20 / $1,207.24 / $1,484.23	Professional		$708.20	$1,207.24	$1,484.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,236.85 / $1,903.49 / $3,308.20	Professional		$1,236.85	$1,903.49	$3,308.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $756.07 / $2,415.73 / $5,761.13	Facility		$756.07	$2,415.73	$5,761.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $551.92 / $756.07 / $6,239.69	Professional		$551.92	$756.07	$6,239.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,236.85 / $1,236.85 / $1,236.85	Professional		$1,236.85	$1,236.85	$1,236.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $987.61 / $1,236.85 / $1,236.85	Professional		$987.61	$1,236.85	$1,236.85
United Facility/Professional Professional Modifier Low / Median / High Price $459.49 / $617.05 / $1,236.85	Professional		$459.49	$617.05	$1,236.85