Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $756.95 / $756.95 / $756.95	Facility		$756.95	$756.95	$756.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $606.29 / $756.95 / $1,151.46	Professional		$606.29	$756.95	$1,151.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,500.51 / $1,650.56 / $2,730.93	Facility		$1,500.51	$1,650.56	$2,730.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,350.45 / $1,395.47 / $1,845.62	Professional		$1,350.45	$1,395.47	$1,845.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,079.46 / $3,211.09 / $3,211.09	Facility		$1,079.46	$3,211.09	$3,211.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,057.34 / $3,102.24 / $6,263.05	Facility		$1,057.34	$3,102.24	$6,263.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $771.87 / $2,174.53 / $2,839.83	Professional		$771.87	$2,174.53	$2,839.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $410.67 / $1,135.43 / $1,725.59	Facility		$410.67	$1,135.43	$1,725.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $859.14 / $1,500.51 / $1,800.61	Professional		$859.14	$1,500.51	$1,800.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $710.88 / $1,500.51 / $6,718.33	Facility		$710.88	$1,500.51	$6,718.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $597.78 / $756.65 / $1,633.87	Professional		$597.78	$756.65	$1,633.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $680.79	Professional		$50.00	$70.00	$680.79
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $410.67 / $1,135.43 / $1,725.59	Facility		$410.67	$1,135.43	$1,725.59
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $859.14 / $1,500.51 / $1,800.61	Professional		$859.14	$1,500.51	$1,800.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,500.51 / $2,309.23 / $3,817.07	Professional		$1,500.51	$2,309.23	$3,817.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,057.34 / $2,930.68 / $6,718.33	Facility		$1,057.34	$2,930.68	$6,718.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $771.87 / $1,057.34 / $9,710.91	Professional		$771.87	$1,057.34	$9,710.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,500.51 / $1,500.51 / $1,500.51	Professional		$1,500.51	$1,500.51	$1,500.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,500.51 / $1,500.51 / $1,500.51	Professional		$1,500.51	$1,500.51	$1,500.51
United Facility/Professional Professional Modifier Low / Median / High Price $530.10 / $748.58 / $1,434.79	Professional		$530.10	$748.58	$1,434.79