Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $679.94 / $679.94 / $679.94	Facility		$679.94	$679.94	$679.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $542.65 / $679.94 / $1,030.59	Professional		$542.65	$679.94	$1,030.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,347.85 / $1,482.64 / $2,453.09	Facility		$1,347.85	$1,482.64	$2,453.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,253.50 / $1,253.50 / $1,657.85	Professional		$1,253.50	$1,253.50	$1,657.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $969.64 / $2,884.40 / $2,884.40	Facility		$969.64	$2,884.40	$2,884.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.02 / $2,786.09 / $5,626.25	Facility		$714.02	$2,786.09	$5,626.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $521.23 / $1,953.28 / $2,550.91	Professional		$521.23	$1,953.28	$2,550.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $368.03 / $1,019.91 / $1,550.03	Facility		$368.03	$1,019.91	$1,550.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $771.74 / $1,347.85 / $1,617.42	Professional		$771.74	$1,347.85	$1,617.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $637.07 / $1,347.85 / $6,061.86	Facility		$637.07	$1,347.85	$6,061.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $536.97 / $678.10 / $1,467.64	Professional		$536.97	$678.10	$1,467.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $548.32	Professional		$50.00	$70.00	$548.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $368.03 / $1,019.91 / $1,550.03	Facility		$368.03	$1,019.91	$1,550.03
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $771.74 / $1,347.85 / $1,617.42	Professional		$771.74	$1,347.85	$1,617.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,347.85 / $2,074.30 / $3,420.61	Professional		$1,347.85	$2,074.30	$3,420.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $714.02 / $2,632.52 / $6,061.86	Facility		$714.02	$2,632.52	$6,061.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $521.23 / $714.02 / $10,365.12	Professional		$521.23	$714.02	$10,365.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,347.85 / $1,347.85 / $1,347.85	Professional		$1,347.85	$1,347.85	$1,347.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,076.22 / $1,347.85 / $1,347.85	Professional		$1,076.22	$1,347.85	$1,347.85
United Facility/Professional Professional Modifier Low / Median / High Price $475.06 / $672.43 / $1,218.85	Professional		$475.06	$672.43	$1,218.85