Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.44 / $545.37 / $545.37	Facility		$168.44	$545.37	$545.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $516.16 / $580.03 / $751.17	Professional		$516.16	$580.03	$751.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,081.08 / $1,189.20 / $1,967.58	Facility		$1,081.08	$1,189.20	$1,967.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $972.98 / $1,005.41 / $1,329.74	Professional		$972.98	$1,005.41	$1,329.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $777.73 / $2,313.53 / $2,313.53	Facility		$777.73	$2,313.53	$2,313.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $702.03 / $2,235.44 / $4,512.18	Facility		$702.03	$2,235.44	$4,512.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.48 / $1,566.56 / $2,046.04	Professional		$512.48	$1,566.56	$2,046.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $311.04 / $818.06 / $1,243.25	Facility		$311.04	$818.06	$1,243.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $618.99 / $1,055.16 / $1,297.31	Professional		$618.99	$1,055.16	$1,297.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $538.42 / $1,081.08 / $5,034.28	Facility		$538.42	$1,081.08	$5,034.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $472.07 / $566.30 / $1,177.18	Professional		$472.07	$566.30	$1,177.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $419.46	Professional		$50.00	$65.00	$419.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $311.04 / $818.06 / $1,243.25	Facility		$311.04	$818.06	$1,243.25
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $618.99 / $1,055.16 / $1,297.31	Professional		$618.99	$1,055.16	$1,297.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,081.08 / $1,663.75 / $2,890.66	Professional		$1,081.08	$1,663.75	$2,890.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $702.03 / $2,111.50 / $5,034.28	Facility		$702.03	$2,111.50	$5,034.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $512.48 / $702.03 / $5,442.94	Professional		$512.48	$702.03	$5,442.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,081.08 / $1,081.08 / $1,081.08	Professional		$1,081.08	$1,081.08	$1,081.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $863.21 / $1,081.08 / $1,081.08	Professional		$863.21	$1,081.08	$1,081.08
United Facility/Professional Professional Modifier Low / Median / High Price $401.51 / $556.84 / $1,033.74	Professional		$401.51	$556.84	$1,033.74