Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $676.01 / $676.01 / $676.01	Facility		$676.01	$676.01	$676.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $676.01 / $744.83 / $1,508.48	Professional		$676.01	$744.83	$1,508.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,340.06 / $1,474.07 / $2,438.91	Facility		$1,340.06	$1,474.07	$2,438.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,206.05 / $1,246.26 / $1,648.27	Professional		$1,206.05	$1,246.26	$1,648.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $964.04 / $2,867.73 / $2,867.73	Facility		$964.04	$2,867.73	$2,867.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $837.35 / $2,770.14 / $5,594.06	Facility		$837.35	$2,770.14	$5,594.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $611.27 / $1,942.03 / $2,536.19	Professional		$611.27	$1,942.03	$2,536.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $431.60 / $1,014.02 / $1,541.07	Facility		$431.60	$1,014.02	$1,541.07
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $767.29 / $1,340.06 / $1,786.75	Professional		$767.29	$1,340.06	$1,786.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $676.01 / $1,340.06 / $7,137.75	Facility		$676.01	$1,340.06	$7,137.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $607.03 / $779.97 / $1,512.90	Professional		$607.03	$779.97	$1,512.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $695.91	Professional		$50.00	$70.00	$695.91
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $431.60 / $1,014.02 / $1,541.07	Facility		$431.60	$1,014.02	$1,541.07
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $767.29 / $1,340.06 / $1,786.75	Professional		$767.29	$1,340.06	$1,786.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,340.06 / $2,062.31 / $4,011.79	Professional		$1,340.06	$2,062.31	$4,011.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $837.35 / $2,617.32 / $7,137.75	Facility		$837.35	$2,617.32	$7,137.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $611.27 / $837.35 / $11,041.83	Professional		$611.27	$837.35	$11,041.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,340.06 / $1,340.06 / $1,340.06	Professional		$1,340.06	$1,340.06	$1,340.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,340.06 / $1,340.06 / $1,340.06	Professional		$1,340.06	$1,340.06	$1,340.06
United Facility/Professional Facility Modifier Low / Median / High Price $1.07 / $704.24 / $874.74	Facility		$1.07	$704.24	$874.74
United Facility/Professional Professional Modifier Low / Median / High Price $533.87 / $742.21 / $1,340.06	Professional		$533.87	$742.21	$1,340.06