Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $692.34 / $692.34 / $692.34	Facility		$692.34	$692.34	$692.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $651.77 / $692.34 / $1,237.81	Professional		$651.77	$692.34	$1,237.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,372.45 / $1,509.70 / $2,497.86	Facility		$1,372.45	$1,509.70	$2,497.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,187.03 / $1,276.38 / $1,688.11	Professional		$1,187.03	$1,276.38	$1,688.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $987.34 / $2,937.04 / $2,937.04	Facility		$987.34	$2,937.04	$2,937.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $969.19 / $3,030.53 / $5,728.42	Facility		$969.19	$3,030.53	$5,728.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.51 / $2,285.77 / $2,597.46	Professional		$707.51	$2,285.77	$2,597.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $442.03 / $1,038.51 / $1,578.32	Facility		$442.03	$1,038.51	$1,578.32
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $785.83 / $1,372.45 / $1,646.94	Professional		$785.83	$1,372.45	$1,646.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $692.34 / $1,371.24 / $7,148.16	Facility		$692.34	$1,371.24	$7,148.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $621.70 / $798.82 / $1,494.42	Professional		$621.70	$798.82	$1,494.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $1,002.35	Professional		$50.00	$65.00	$1,002.35
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $442.03 / $1,038.51 / $1,578.32	Facility		$442.03	$1,038.51	$1,578.32
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $785.83 / $1,372.45 / $1,646.94	Professional		$785.83	$1,372.45	$1,646.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,372.45 / $2,112.17 / $4,108.14	Professional		$1,372.45	$2,112.17	$4,108.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $969.19 / $2,680.56 / $7,148.16	Facility		$969.19	$2,680.56	$7,148.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $707.51 / $969.19 / $9,113.04	Professional		$707.51	$969.19	$9,113.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,372.45 / $1,372.45 / $1,372.45	Professional		$1,372.45	$1,372.45	$1,372.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,095.85 / $1,372.45 / $1,372.45	Professional		$1,095.85	$1,372.45	$1,372.45
United Facility/Professional Professional Modifier Low / Median / High Price $546.77 / $685.82 / $1,312.35	Professional		$546.77	$685.82	$1,312.35