Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $787.42 / $787.42 / $787.42	Facility		$787.42	$787.42	$787.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.76 / $787.42 / $1,084.56	Professional		$758.76	$787.42	$1,084.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,560.91 / $1,717.00 / $2,840.86	Facility		$1,560.91	$1,717.00	$2,840.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,451.65 / $1,451.65 / $1,919.91	Professional		$1,451.65	$1,451.65	$1,919.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,122.92 / $3,340.35 / $3,340.35	Facility		$1,122.92	$3,340.35	$3,340.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $906.54 / $3,446.31 / $6,514.97	Facility		$906.54	$3,446.31	$6,514.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $661.77 / $2,298.38 / $2,954.15	Professional		$661.77	$2,298.38	$2,954.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $406.89 / $1,181.13 / $1,795.05	Facility		$406.89	$1,181.13	$1,795.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $893.73 / $1,422.76 / $1,873.09	Professional		$893.73	$1,422.76	$1,873.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $704.34 / $1,560.91 / $6,665.91	Facility		$704.34	$1,560.91	$6,665.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $624.64 / $778.72 / $1,699.64	Professional		$624.64	$778.72	$1,699.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $848.84	Professional		$50.00	$65.00	$848.84
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $406.89 / $1,181.13 / $1,795.05	Facility		$406.89	$1,181.13	$1,795.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $893.73 / $1,422.76 / $1,873.09	Professional		$893.73	$1,422.76	$1,873.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,560.91 / $2,341.37 / $3,781.94	Professional		$1,560.91	$2,341.37	$3,781.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $906.54 / $3,048.66 / $6,665.91	Facility		$906.54	$3,048.66	$6,665.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $661.77 / $906.54 / $7,284.37	Professional		$661.77	$906.54	$7,284.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,560.91 / $1,560.91 / $1,560.91	Professional		$1,560.91	$1,560.91	$1,560.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,246.33 / $1,560.91 / $1,560.91	Professional		$1,246.33	$1,560.91	$1,560.91
United Facility/Professional Professional Modifier Low / Median / High Price $525.22 / $778.72 / $1,492.55	Professional		$525.22	$778.72	$1,492.55