Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $669.81 / $669.81 / $669.81	Facility		$669.81	$669.81	$669.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $624.70 / $669.81 / $1,186.43	Professional		$624.70	$669.81	$1,186.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,327.77 / $1,460.55 / $2,416.54	Facility		$1,327.77	$1,460.55	$2,416.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.39 / $1,234.83 / $1,633.15	Professional		$1,148.39	$1,234.83	$1,633.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $955.19 / $2,841.43 / $2,841.43	Facility		$955.19	$2,841.43	$2,841.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $830.86 / $2,744.84 / $5,542.27	Facility		$830.86	$2,744.84	$5,542.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $606.53 / $1,924.22 / $2,512.91	Professional		$606.53	$1,924.22	$2,512.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $423.68 / $1,004.72 / $1,526.94	Facility		$423.68	$1,004.72	$1,526.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $760.24 / $1,327.77 / $1,753.95	Professional		$760.24	$1,327.77	$1,753.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $669.81 / $1,394.16 / $7,008.49	Facility		$669.81	$1,394.16	$7,008.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $598.09 / $765.65 / $1,499.02	Professional		$598.09	$765.65	$1,499.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $852.24	Professional		$50.00	$70.00	$852.24
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $423.68 / $1,004.72 / $1,526.94	Facility		$423.68	$1,004.72	$1,526.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $760.24 / $1,327.77 / $1,753.95	Professional		$760.24	$1,327.77	$1,753.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,327.77 / $2,043.39 / $3,937.52	Professional		$1,327.77	$2,043.39	$3,937.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $830.86 / $2,593.30 / $7,008.49	Facility		$830.86	$2,593.30	$7,008.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $606.53 / $830.86 / $12,940.74	Professional		$606.53	$830.86	$12,940.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,327.77 / $1,327.77 / $1,327.77	Professional		$1,327.77	$1,327.77	$1,327.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,060.19 / $1,327.77 / $1,327.77	Professional		$1,060.19	$1,327.77	$1,327.77
United Facility/Professional Facility Modifier Low / Median / High Price $876.64 / $876.64 / $876.64	Facility		$876.64	$876.64	$876.64
United Facility/Professional Professional Modifier Low / Median / High Price $528.96 / $662.41 / $1,229.33	Professional		$528.96	$662.41	$1,229.33