Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $509.14 / $509.14 / $509.14	Facility		$509.14	$509.14	$509.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $509.14 / $553.04 / $701.27	Professional		$509.14	$553.04	$701.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,009.29 / $1,110.22 / $1,836.91	Facility		$1,009.29	$1,110.22	$1,836.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $938.64 / $938.64 / $1,241.42	Professional		$938.64	$938.64	$1,241.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $726.08 / $2,159.88 / $2,159.88	Facility		$726.08	$2,159.88	$2,159.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $632.51 / $2,086.28 / $4,212.68	Facility		$632.51	$2,086.28	$4,212.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $461.73 / $1,462.50 / $1,910.15	Professional		$461.73	$1,462.50	$1,910.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $296.57 / $763.71 / $1,160.68	Facility		$296.57	$763.71	$1,160.68
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $577.88 / $920.83 / $1,211.15	Professional		$577.88	$920.83	$1,211.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $509.14 / $1,009.29 / $4,802.66	Facility		$509.14	$1,009.29	$4,802.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $424.74 / $537.34 / $1,098.98	Professional		$424.74	$537.34	$1,098.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $621.27	Professional		$50.00	$65.00	$621.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $296.57 / $763.71 / $1,160.68	Facility		$296.57	$763.71	$1,160.68
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $577.88 / $920.83 / $1,211.15	Professional		$577.88	$920.83	$1,211.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,009.29 / $1,553.24 / $2,756.16	Professional		$1,009.29	$1,553.24	$2,756.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $632.51 / $1,971.26 / $4,802.66	Facility		$632.51	$1,971.26	$4,802.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $461.73 / $632.51 / $5,555.28	Professional		$461.73	$632.51	$5,555.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,009.29 / $1,009.29 / $1,009.29	Professional		$1,009.29	$1,009.29	$1,009.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $805.88 / $1,009.29 / $1,009.29	Professional		$805.88	$1,009.29	$1,009.29
United Facility/Professional Professional Modifier Low / Median / High Price $359.70 / $503.52 / $965.08	Professional		$359.70	$503.52	$965.08