Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $607.34 / $607.34 / $607.34	Facility		$607.34	$607.34	$607.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $607.34 / $611.73 / $1,161.78	Professional		$607.34	$611.73	$1,161.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,203.94 / $1,324.33 / $2,191.17	Facility		$1,203.94	$1,324.33	$2,191.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,119.66 / $1,119.66 / $1,480.84	Professional		$1,119.66	$1,119.66	$1,480.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $866.11 / $2,576.42 / $2,576.42	Facility		$866.11	$2,576.42	$2,576.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $711.81 / $2,657.88 / $5,025.83	Facility		$711.81	$2,657.88	$5,025.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $519.62 / $1,772.60 / $2,278.55	Professional		$519.62	$1,772.60	$2,278.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $347.31 / $911.01 / $1,384.53	Facility		$347.31	$911.01	$1,384.53
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $689.35 / $1,203.94 / $1,444.73	Professional		$689.35	$1,203.94	$1,444.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $601.22 / $1,203.94 / $5,716.25	Facility		$601.22	$1,203.94	$5,716.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $533.17 / $630.66 / $1,344.96	Professional		$533.17	$630.66	$1,344.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $812.49	Professional		$50.00	$70.00	$812.49
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $347.31 / $911.01 / $1,384.53	Facility		$347.31	$911.01	$1,384.53
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $689.35 / $1,203.94 / $1,444.73	Professional		$689.35	$1,203.94	$1,444.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,203.94 / $1,852.82 / $3,227.90	Professional		$1,203.94	$1,852.82	$3,227.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $711.81 / $2,351.44 / $5,716.25	Facility		$711.81	$2,351.44	$5,716.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $519.62 / $711.81 / $8,653.64	Professional		$519.62	$711.81	$8,653.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,203.94 / $1,203.94 / $1,203.94	Professional		$1,203.94	$1,203.94	$1,203.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $961.32 / $1,203.94 / $1,203.94	Professional		$961.32	$1,203.94	$1,203.94
United Facility/Professional Professional Modifier Low / Median / High Price $421.24 / $601.58 / $1,151.21	Professional		$421.24	$601.58	$1,151.21