Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $945.64 / $945.64 / $945.64	Facility		$945.64	$945.64	$945.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $925.49 / $945.64 / $1,757.66	Professional		$925.49	$945.64	$1,757.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,874.55 / $2,062.01 / $3,411.68	Facility		$1,874.55	$2,062.01	$3,411.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,743.33 / $1,743.33 / $2,305.69	Professional		$1,743.33	$1,743.33	$2,305.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,348.55 / $4,011.54 / $4,011.54	Facility		$1,348.55	$4,011.54	$4,011.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,212.63 / $3,875.19 / $7,824.96	Facility		$1,212.63	$3,875.19	$7,824.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $885.22 / $2,716.41 / $3,547.74	Professional		$885.22	$2,716.41	$3,547.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $554.10 / $1,418.46 / $2,155.73	Facility		$554.10	$1,418.46	$2,155.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,073.33 / $1,874.55 / $2,293.90	Professional		$1,073.33	$1,874.55	$2,293.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $945.64 / $1,874.55 / $9,141.02	Facility		$945.64	$1,874.55	$9,141.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $844.40 / $1,001.35 / $2,116.35	Professional		$844.40	$1,001.35	$2,116.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $907.90	Professional		$50.00	$70.00	$907.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $554.10 / $1,418.46 / $2,155.73	Facility		$554.10	$1,418.46	$2,155.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,073.33 / $1,874.55 / $2,293.90	Professional		$1,073.33	$1,874.55	$2,293.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,874.55 / $2,884.90 / $5,149.97	Professional		$1,874.55	$2,884.90	$5,149.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,212.63 / $3,661.24 / $9,141.02	Facility		$1,212.63	$3,661.24	$9,141.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $885.22 / $1,212.63 / $13,504.73	Professional		$885.22	$1,212.63	$13,504.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,874.55 / $1,874.55 / $1,874.55	Professional		$1,874.55	$1,874.55	$1,874.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,874.55 / $1,874.55 / $1,874.55	Professional		$1,874.55	$1,874.55	$1,874.55
United Facility/Professional Professional Modifier Low / Median / High Price $715.25 / $981.96 / $1,835.12	Professional		$715.25	$981.96	$1,835.12