Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $542.36 / $542.36 / $542.36	Facility		$542.36	$542.36	$542.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $513.36 / $552.60 / $885.97	Professional		$513.36	$552.60	$885.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,075.14 / $1,182.65 / $1,956.75	Facility		$1,075.14	$1,182.65	$1,956.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $929.88 / $999.88 / $1,322.42	Professional		$929.88	$999.88	$1,322.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $773.46 / $2,300.80 / $2,300.80	Facility		$773.46	$2,300.80	$2,300.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $731.38 / $2,374.34 / $4,488.39	Facility		$731.38	$2,374.34	$4,488.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $1,583.06 / $2,034.79	Professional		$533.91	$1,583.06	$2,034.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $309.33 / $813.54 / $1,236.41	Facility		$309.33	$813.54	$1,236.41
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $615.62 / $1,049.40 / $1,290.17	Professional		$615.62	$1,049.40	$1,290.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $535.49 / $1,075.14 / $5,006.71	Facility		$535.49	$1,075.14	$5,006.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $469.48 / $569.97 / $1,170.69	Professional		$469.48	$569.97	$1,170.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $404.00	Professional		$50.00	$70.00	$404.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $309.33 / $813.54 / $1,236.41	Facility		$309.33	$813.54	$1,236.41
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $615.62 / $1,049.40 / $1,290.17	Professional		$615.62	$1,049.40	$1,290.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,075.14 / $1,654.61 / $2,875.60	Professional		$1,075.14	$1,654.61	$2,875.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $731.38 / $2,099.88 / $5,006.71	Facility		$731.38	$2,099.88	$5,006.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $731.38 / $5,412.81	Professional		$533.91	$731.38	$5,412.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,075.14 / $1,075.14 / $1,075.14	Professional		$1,075.14	$1,075.14	$1,075.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $858.50 / $1,075.14 / $1,075.14	Professional		$858.50	$1,075.14	$1,075.14
United Facility/Professional Professional Modifier Low / Median / High Price $428.33 / $536.38 / $1,028.05	Professional		$428.33	$536.38	$1,028.05