Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $636.00 / $636.00 / $636.00	Facility		$636.00	$636.00	$636.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $601.98 / $636.00 / $1,143.26	Professional		$601.98	$636.00	$1,143.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,260.75 / $1,386.83 / $2,294.57	Facility		$1,260.75	$1,386.83	$2,294.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,134.67 / $1,172.50 / $1,550.72	Professional		$1,134.67	$1,172.50	$1,550.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $906.98 / $2,698.01 / $2,698.01	Facility		$906.98	$2,698.01	$2,698.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.89 / $2,784.10 / $5,262.36	Facility		$741.89	$2,784.10	$5,262.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $541.58 / $1,856.42 / $2,386.06	Professional		$541.58	$1,856.42	$2,386.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $362.74 / $954.00 / $1,449.86	Facility		$362.74	$954.00	$1,449.86
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $721.88 / $1,230.58 / $1,512.90	Professional		$721.88	$1,230.58	$1,512.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $627.91 / $1,260.75 / $5,871.01	Facility		$627.91	$1,260.75	$5,871.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $550.54 / $660.42 / $1,372.80	Professional		$550.54	$660.42	$1,372.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $850.83	Professional		$50.00	$70.00	$850.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $362.74 / $954.00 / $1,449.86	Facility		$362.74	$954.00	$1,449.86
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $721.88 / $1,230.58 / $1,512.90	Professional		$721.88	$1,230.58	$1,512.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,260.75 / $1,940.26 / $3,371.43	Professional		$1,260.75	$1,940.26	$3,371.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $741.89 / $2,462.40 / $5,871.01	Facility		$741.89	$2,462.40	$5,871.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $541.58 / $741.89 / $6,347.36	Professional		$541.58	$741.89	$6,347.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,260.75 / $1,260.75 / $1,260.75	Professional		$1,260.75	$1,260.75	$1,260.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,006.69 / $1,260.75 / $1,260.75	Professional		$1,006.69	$1,260.75	$1,260.75
United Facility/Professional Professional Modifier Low / Median / High Price $502.27 / $628.97 / $1,205.53	Professional		$502.27	$628.97	$1,205.53