Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $569.53 / $654.95 / $654.95	Facility		$569.53	$654.95	$654.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $532.85 / $571.20 / $784.44	Professional		$532.85	$571.20	$784.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,128.98 / $1,241.88 / $2,054.73	Facility		$1,128.98	$1,241.88	$2,054.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,016.08 / $1,049.95 / $1,388.64	Professional		$1,016.08	$1,049.95	$1,388.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $812.18 / $2,416.02 / $2,416.02	Facility		$812.18	$2,416.02	$2,416.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $2,333.94 / $4,712.33	Facility		$700.00	$2,333.94	$4,712.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $511.00 / $1,635.94 / $2,136.69	Professional		$511.00	$1,635.94	$2,136.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $330.98 / $854.30 / $1,298.33	Facility		$330.98	$854.30	$1,298.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $646.44 / $1,128.98 / $1,370.23	Professional		$646.44	$1,128.98	$1,370.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $569.53 / $1,130.44 / $5,530.59	Facility		$569.53	$1,130.44	$5,530.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $474.02 / $609.85 / $1,241.88	Professional		$474.02	$609.85	$1,241.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $769.53	Professional		$50.00	$70.00	$769.53
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $330.98 / $854.30 / $1,298.33	Facility		$330.98	$854.30	$1,298.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $646.44 / $1,128.98 / $1,370.23	Professional		$646.44	$1,128.98	$1,370.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,128.98 / $1,737.45 / $3,076.34	Professional		$1,128.98	$1,737.45	$3,076.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $2,205.04 / $5,530.59	Facility		$700.00	$2,205.04	$5,530.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $511.00 / $700.00 / $6,973.74	Professional		$511.00	$700.00	$6,973.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,128.98 / $1,128.98 / $1,128.98	Professional		$1,128.98	$1,128.98	$1,128.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $901.48 / $1,128.98 / $1,128.98	Professional		$901.48	$1,128.98	$1,128.98
United Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $480.00 / $480.00	Facility		$480.00	$480.00	$480.00
United Facility/Professional Professional Modifier Low / Median / High Price $427.25 / $563.23 / $1,096.18	Professional		$427.25	$563.23	$1,096.18