Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.10 / $776.10 / $776.10	Facility		$776.10	$776.10	$776.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $727.97 / $776.10 / $1,382.54	Professional		$727.97	$776.10	$1,382.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,538.47 / $1,692.32 / $2,800.02	Facility		$1,538.47	$1,692.32	$2,800.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,384.62 / $1,430.78 / $1,892.31	Professional		$1,384.62	$1,430.78	$1,892.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,106.78 / $3,292.33 / $3,292.33	Facility		$1,106.78	$3,292.33	$3,292.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.96 / $3,181.02 / $6,421.20	Facility		$842.96	$3,181.02	$6,421.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $615.36 / $2,229.38 / $2,911.68	Professional		$615.36	$2,229.38	$2,911.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $434.49 / $1,164.15 / $1,769.24	Facility		$434.49	$1,164.15	$1,769.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $880.90 / $1,538.47 / $1,846.16	Professional		$880.90	$1,538.47	$1,846.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $752.12 / $1,538.47 / $7,102.37	Facility		$752.12	$1,538.47	$7,102.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $622.27 / $800.56 / $1,675.20	Professional		$622.27	$800.56	$1,675.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $922.83	Professional		$50.00	$70.00	$922.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $434.49 / $1,164.15 / $1,769.24	Facility		$434.49	$1,164.15	$1,769.24
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $880.90 / $1,538.47 / $1,846.16	Professional		$880.90	$1,538.47	$1,846.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,538.47 / $2,367.66 / $4,037.89	Professional		$1,538.47	$2,367.66	$4,037.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $842.96 / $3,004.82 / $7,102.37	Facility		$842.96	$3,004.82	$7,102.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $615.36 / $842.96 / $8,633.90	Professional		$615.36	$842.96	$8,633.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,538.47 / $1,538.47 / $1,538.47	Professional		$1,538.47	$1,538.47	$1,538.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,538.47 / $1,538.47 / $1,538.47	Professional		$1,538.47	$1,538.47	$1,538.47
United Facility/Professional Professional Modifier Low / Median / High Price $560.86 / $767.53 / $1,489.49	Professional		$560.86	$767.53	$1,489.49