Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $824.06 / $824.06 / $824.06	Facility		$824.06	$824.06	$824.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $824.06 / $902.65 / $1,714.29	Professional		$824.06	$902.65	$1,714.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,633.55 / $1,796.91 / $2,973.06	Facility		$1,633.55	$1,796.91	$2,973.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,470.19 / $1,519.20 / $2,009.26	Professional		$1,470.19	$1,519.20	$2,009.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,175.17 / $3,495.80 / $3,495.80	Facility		$1,175.17	$3,495.80	$3,495.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,030.36 / $3,606.59 / $6,818.68	Facility		$1,030.36	$3,606.59	$6,818.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $752.17 / $2,720.62 / $3,091.61	Professional		$752.17	$2,720.62	$3,091.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $514.15 / $1,236.08 / $1,878.58	Facility		$514.15	$1,236.08	$1,878.58
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $935.31 / $1,633.55 / $2,128.51	Professional		$935.31	$1,633.55	$2,128.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $824.06 / $1,633.55 / $8,437.43	Facility		$824.06	$1,633.55	$8,437.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $735.82 / $947.33 / $1,844.21	Professional		$735.82	$947.33	$1,844.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,102.38	Professional		$50.00	$70.00	$1,102.38
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $514.15 / $1,236.08 / $1,878.58	Facility		$514.15	$1,236.08	$1,878.58
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $935.31 / $1,633.55 / $2,128.51	Professional		$935.31	$1,633.55	$2,128.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,633.55 / $2,513.94 / $4,778.62	Professional		$1,633.55	$2,513.94	$4,778.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,030.36 / $3,190.52 / $8,437.43	Facility		$1,030.36	$3,190.52	$8,437.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $752.17 / $1,030.36 / $10,969.29	Professional		$752.17	$1,030.36	$10,969.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,633.55 / $1,633.55 / $1,633.55	Professional		$1,633.55	$1,633.55	$1,633.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,633.55 / $1,633.55 / $1,633.55	Professional		$1,633.55	$1,633.55	$1,633.55
United Facility/Professional Professional Modifier Low / Median / High Price $623.59 / $884.18 / $1,633.55	Professional		$623.59	$884.18	$1,633.55