Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $801.65 / $801.65 / $801.65	Facility		$801.65	$801.65	$801.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.74 / $801.65 / $1,440.99	Professional		$758.74	$801.65	$1,440.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,589.13 / $1,748.04 / $2,892.22	Facility		$1,589.13	$1,748.04	$2,892.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,374.43 / $1,477.89 / $1,954.62	Professional		$1,374.43	$1,477.89	$1,954.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,143.22 / $3,400.74 / $3,400.74	Facility		$1,143.22	$3,400.74	$3,400.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,115.23 / $3,508.42 / $6,632.53	Facility		$1,115.23	$3,508.42	$6,632.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $814.12 / $2,339.82 / $3,007.54	Professional		$814.12	$2,339.82	$3,007.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $457.21 / $1,202.48 / $1,827.50	Facility		$457.21	$1,202.48	$1,827.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $909.90 / $1,551.00 / $1,906.96	Professional		$909.90	$1,551.00	$1,906.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $791.46 / $1,589.13 / $7,399.97	Facility		$791.46	$1,589.13	$7,399.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $693.91 / $832.44 / $1,730.36	Professional		$693.91	$832.44	$1,730.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,072.43	Professional		$50.00	$70.00	$1,072.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $457.21 / $1,202.48 / $1,827.50	Facility		$457.21	$1,202.48	$1,827.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $909.90 / $1,551.00 / $1,906.96	Professional		$909.90	$1,551.00	$1,906.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,589.13 / $2,445.61 / $4,249.67	Professional		$1,589.13	$2,445.61	$4,249.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,115.23 / $3,103.76 / $7,399.97	Facility		$1,115.23	$3,103.76	$7,399.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $814.12 / $1,115.23 / $8,000.67	Professional		$814.12	$1,115.23	$8,000.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,589.13 / $1,589.13 / $1,589.13	Professional		$1,589.13	$1,589.13	$1,589.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,268.88 / $1,589.13 / $1,589.13	Professional		$1,268.88	$1,589.13	$1,589.13
United Facility/Professional Professional Modifier Low / Median / High Price $554.53 / $792.80 / $1,519.53	Professional		$554.53	$792.80	$1,519.53