Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $658.37 / $658.37 / $658.37	Facility		$658.37	$658.37	$658.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $541.99 / $658.37 / $1,029.33	Professional		$541.99	$658.37	$1,029.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,305.08 / $1,435.60 / $2,375.26	Facility		$1,305.08	$1,435.60	$2,375.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.58 / $1,213.73 / $1,605.26	Professional		$1,174.58	$1,213.73	$1,605.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $938.88 / $2,792.89 / $2,792.89	Facility		$938.88	$2,792.89	$2,792.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $713.15 / $2,697.93 / $5,447.10	Facility		$713.15	$2,697.93	$5,447.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $520.60 / $1,891.41 / $2,469.98	Professional		$520.60	$1,891.41	$2,469.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $367.58 / $987.56 / $1,500.85	Facility		$367.58	$987.56	$1,500.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $747.26 / $1,305.08 / $1,566.11	Professional		$747.26	$1,305.08	$1,566.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $636.29 / $1,305.08 / $6,073.14	Facility		$636.29	$1,305.08	$6,073.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $526.42 / $677.27 / $1,423.44	Professional		$526.42	$677.27	$1,423.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $777.12	Professional		$50.00	$70.00	$777.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $367.58 / $987.56 / $1,500.85	Facility		$367.58	$987.56	$1,500.85
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $747.26 / $1,305.08 / $1,566.11	Professional		$747.26	$1,305.08	$1,566.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,305.08 / $2,008.50 / $3,416.59	Professional		$1,305.08	$2,008.50	$3,416.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $713.15 / $2,549.00 / $6,073.14	Facility		$713.15	$2,549.00	$6,073.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $520.60 / $713.15 / $7,833.15	Professional		$520.60	$713.15	$7,833.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,305.08 / $1,305.08 / $1,305.08	Professional		$1,305.08	$1,305.08	$1,305.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,305.08 / $1,305.08 / $1,305.08	Professional		$1,305.08	$1,305.08	$1,305.08
United Facility/Professional Professional Modifier Low / Median / High Price $474.48 / $664.27 / $1,305.08	Professional		$474.48	$664.27	$1,305.08