Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $692.46 / $692.46 / $692.46	Facility		$692.46	$692.46	$692.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $692.46 / $752.75 / $1,429.61	Professional		$692.46	$752.75	$1,429.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,372.66 / $1,509.93 / $2,498.23	Facility		$1,372.66	$1,509.93	$2,498.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,276.57 / $1,276.57 / $1,688.37	Professional		$1,276.57	$1,276.57	$1,688.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $987.49 / $2,937.49 / $2,937.49	Facility		$987.49	$2,937.49	$2,937.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $857.71 / $2,837.70 / $5,729.82	Facility		$857.71	$2,837.70	$5,729.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $626.13 / $1,989.38 / $2,597.88	Professional		$626.13	$1,989.38	$2,597.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $442.10 / $1,038.69 / $1,578.56	Facility		$442.10	$1,038.69	$1,578.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $785.95 / $1,372.66 / $1,830.22	Professional		$785.95	$1,372.66	$1,830.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $692.46 / $1,437.66 / $7,331.22	Facility		$692.46	$1,437.66	$7,331.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $621.79 / $814.58 / $1,549.72	Professional		$621.79	$814.58	$1,549.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $437.59	Professional		$50.00	$70.00	$437.59
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $442.10 / $1,038.69 / $1,578.56	Facility		$442.10	$1,038.69	$1,578.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $785.95 / $1,372.66 / $1,830.22	Professional		$785.95	$1,372.66	$1,830.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,372.66 / $2,112.50 / $4,109.14	Professional		$1,372.66	$2,112.50	$4,109.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $857.71 / $2,680.98 / $7,331.22	Facility		$857.71	$2,680.98	$7,331.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $626.13 / $857.72 / $12,955.37	Professional		$626.13	$857.72	$12,955.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,372.66 / $1,372.66 / $1,372.66	Professional		$1,372.66	$1,372.66	$1,372.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.04 / $1,372.66 / $1,372.66	Professional		$1,096.04	$1,372.66	$1,372.66
United Facility/Professional Professional Modifier Low / Median / High Price $546.85 / $791.45 / $1,282.80	Professional		$546.85	$791.45	$1,282.80