Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $682.25 / $682.25 / $682.25	Facility		$682.25	$682.25	$682.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $525.24 / $682.25 / $987.85	Professional		$525.24	$682.25	$987.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,352.44 / $1,487.68 / $2,461.44	Facility		$1,352.44	$1,487.68	$2,461.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,257.77 / $1,257.77 / $1,663.50	Professional		$1,257.77	$1,257.77	$1,663.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $972.94 / $2,894.22 / $2,894.22	Facility		$972.94	$2,894.22	$2,894.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $769.23 / $2,796.42 / $5,645.84	Facility		$769.23	$2,796.42	$5,645.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $561.54 / $1,959.84 / $2,559.60	Professional		$561.54	$1,959.84	$2,559.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $335.88 / $1,023.38 / $1,555.31	Facility		$335.88	$1,023.38	$1,555.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $774.37 / $1,352.44 / $1,622.93	Professional		$774.37	$1,352.44	$1,622.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $581.42 / $1,352.44 / $5,627.79	Facility		$581.42	$1,352.44	$5,627.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $515.63 / $674.71 / $1,472.64	Professional		$515.63	$674.71	$1,472.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $778.58	Professional		$50.00	$70.00	$778.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $335.88 / $1,023.38 / $1,555.31	Facility		$335.88	$1,023.38	$1,555.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $774.37 / $1,352.44 / $1,622.93	Professional		$774.37	$1,352.44	$1,622.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,352.44 / $2,028.66 / $3,121.51	Professional		$1,352.44	$2,028.66	$3,121.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $769.23 / $2,641.48 / $5,627.79	Facility		$769.23	$2,641.48	$5,627.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $561.54 / $769.23 / $6,674.40	Professional		$561.54	$769.23	$6,674.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,352.44 / $1,352.44 / $1,352.44	Professional		$1,352.44	$1,352.44	$1,352.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,079.88 / $1,352.44 / $1,352.44	Professional		$1,079.88	$1,352.44	$1,352.44
United Facility/Professional Professional Modifier Low / Median / High Price $449.81 / $674.71 / $1,199.08	Professional		$449.81	$674.71	$1,199.08