Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $530.34 / $530.34 / $530.34	Facility		$530.34	$530.34	$530.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $494.68 / $530.34 / $939.48	Professional		$494.68	$530.34	$939.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,051.31 / $1,156.44 / $1,913.38	Facility		$1,051.31	$1,156.44	$1,913.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $946.17 / $977.72 / $1,293.10	Professional		$946.17	$977.72	$1,293.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $756.31 / $2,249.80 / $2,249.80	Facility		$756.31	$2,249.80	$2,249.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $740.83 / $2,173.53 / $4,387.63	Facility		$740.83	$2,173.53	$4,387.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $540.80 / $1,523.44 / $1,989.69	Professional		$540.80	$1,523.44	$1,989.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $335.49 / $795.51 / $1,209.01	Facility		$335.49	$795.51	$1,209.01
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $601.95 / $1,051.31 / $1,388.89	Professional		$601.95	$1,051.31	$1,388.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $530.34 / $1,103.88 / $5,601.21	Facility		$530.34	$1,103.88	$5,601.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $473.56 / $606.29 / $1,186.91	Professional		$473.56	$606.29	$1,186.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $669.57	Professional		$50.00	$70.00	$669.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $335.49 / $795.51 / $1,209.01	Facility		$335.49	$795.51	$1,209.01
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $601.95 / $1,051.31 / $1,388.89	Professional		$601.95	$1,051.31	$1,388.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,051.31 / $1,617.92 / $3,118.50	Professional		$1,051.31	$1,617.92	$3,118.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $740.83 / $2,053.34 / $5,601.21	Facility		$740.83	$2,053.34	$5,601.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $540.80 / $740.83 / $9,057.24	Professional		$540.80	$740.83	$9,057.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,051.31 / $1,051.31 / $1,051.31	Professional		$1,051.31	$1,051.31	$1,051.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $839.44 / $1,051.31 / $1,051.31	Professional		$839.44	$1,051.31	$1,051.31
United Facility/Professional Professional Modifier Low / Median / High Price $418.83 / $524.48 / $1,005.26	Professional		$418.83	$524.48	$1,005.26