Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $571.58 / $571.58 / $571.58	Facility		$571.58	$571.58	$571.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $536.34 / $571.58 / $1,018.61	Professional		$536.34	$571.58	$1,018.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,133.06 / $1,246.36 / $2,062.17	Facility		$1,133.06	$1,246.36	$2,062.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $979.98 / $1,053.75 / $1,393.66	Professional		$979.98	$1,053.75	$1,393.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $815.12 / $2,424.75 / $2,424.75	Facility		$815.12	$2,424.75	$2,424.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $732.96 / $2,342.40 / $4,729.13	Facility		$732.96	$2,342.40	$4,729.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $535.05 / $1,887.07 / $2,144.40	Professional		$535.05	$1,887.07	$2,144.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $333.63 / $857.37 / $1,303.02	Facility		$333.63	$857.37	$1,303.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $648.76 / $1,133.06 / $1,381.17	Professional		$648.76	$1,133.06	$1,381.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $571.58 / $1,133.06 / $5,476.21	Facility		$571.58	$1,133.06	$5,476.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $489.53 / $602.91 / $1,279.20	Professional		$489.53	$602.91	$1,279.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $358.62	Professional		$50.00	$70.00	$358.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $333.63 / $857.37 / $1,303.02	Facility		$333.63	$857.37	$1,303.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $648.76 / $1,133.06 / $1,381.17	Professional		$648.76	$1,133.06	$1,381.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,133.06 / $1,743.76 / $3,100.43	Professional		$1,133.06	$1,743.76	$3,100.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $732.96 / $2,213.00 / $5,476.21	Facility		$732.96	$2,213.00	$5,476.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $535.05 / $732.96 / $6,629.62	Professional		$535.05	$732.96	$6,629.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,133.06 / $1,133.06 / $1,133.06	Professional		$1,133.06	$1,133.06	$1,133.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $904.72 / $1,133.06 / $1,133.06	Professional		$904.72	$1,133.06	$1,133.06
United Facility/Professional Facility Modifier Low / Median / High Price $1,657.40 / $1,657.40 / $1,657.40	Facility		$1,657.40	$1,657.40	$1,657.40
United Facility/Professional Professional Modifier Low / Median / High Price $451.40 / $573.73 / $1,083.44	Professional		$451.40	$573.73	$1,083.44