Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $925.59 / $925.59 / $925.59	Facility		$925.59	$925.59	$925.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $894.41 / $932.92 / $1,682.15	Professional		$894.41	$932.92	$1,682.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,834.81 / $2,018.29 / $3,339.35	Facility		$1,834.81	$2,018.29	$3,339.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,651.32 / $1,706.37 / $2,256.81	Professional		$1,651.32	$1,706.37	$2,256.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,319.96 / $3,926.49 / $3,926.49	Facility		$1,319.96	$3,926.49	$3,926.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,186.93 / $3,793.60 / $7,658.41	Facility		$1,186.93	$3,793.60	$7,658.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $866.46 / $2,658.75 / $3,472.53	Professional		$866.46	$2,658.75	$3,472.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $576.95 / $1,388.39 / $2,110.03	Facility		$576.95	$1,388.39	$2,110.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,050.58 / $1,834.81 / $2,388.46	Professional		$1,050.58	$1,834.81	$2,388.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $925.59 / $1,834.81 / $9,309.60	Facility		$925.59	$1,834.81	$9,309.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $826.28 / $1,063.04 / $2,071.48	Professional		$826.28	$1,063.04	$2,071.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $605.14	Professional		$50.00	$70.00	$605.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $576.95 / $1,388.39 / $2,110.03	Facility		$576.95	$1,388.39	$2,110.03
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,050.58 / $1,834.81 / $2,388.46	Professional		$1,050.58	$1,834.81	$2,388.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,834.81 / $2,823.70 / $5,362.77	Professional		$1,834.81	$2,823.70	$5,362.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,186.93 / $3,583.62 / $9,309.60	Facility		$1,186.93	$3,583.62	$9,309.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $866.46 / $1,186.93 / $11,732.79	Professional		$866.46	$1,186.93	$11,732.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,834.81 / $1,834.81 / $1,834.81	Professional		$1,834.81	$1,834.81	$1,834.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,465.06 / $1,834.81 / $1,834.81	Professional		$1,465.06	$1,834.81	$1,834.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,193.78 / $1,193.78 / $1,193.78	Facility		$1,193.78	$1,193.78	$1,193.78
United Facility/Professional Professional Modifier Low / Median / High Price $730.97 / $992.17 / $1,674.09	Professional		$730.97	$992.17	$1,674.09