Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $700.43 / $700.43 / $700.43	Facility		$700.43	$700.43	$700.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $517.45 / $700.43 / $982.72	Professional		$517.45	$700.43	$982.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,388.47 / $1,527.32 / $2,527.02	Facility		$1,388.47	$1,527.32	$2,527.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,249.61 / $1,291.28 / $1,707.81	Professional		$1,249.61	$1,291.28	$1,707.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $998.86 / $2,971.33 / $2,971.33	Facility		$998.86	$2,971.33	$2,971.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $680.86 / $2,870.53 / $5,795.59	Facility		$680.86	$2,870.53	$5,795.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $497.03 / $2,011.88 / $2,627.79	Professional		$497.03	$2,011.88	$2,627.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $350.94 / $1,050.65 / $1,596.74	Facility		$350.94	$1,050.65	$1,596.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $795.00 / $1,388.47 / $1,666.16	Professional		$795.00	$1,388.47	$1,666.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $607.48 / $1,388.47 / $5,885.29	Facility		$607.48	$1,388.47	$5,885.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $538.75 / $692.69 / $1,511.88	Professional		$538.75	$692.69	$1,511.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $738.12	Professional		$50.00	$70.00	$738.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $350.94 / $1,050.65 / $1,596.74	Facility		$350.94	$1,050.65	$1,596.74
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $795.00 / $1,388.47 / $1,666.16	Professional		$795.00	$1,388.47	$1,666.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,388.47 / $2,082.71 / $3,262.03	Professional		$1,388.47	$2,082.71	$3,262.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $680.86 / $2,711.86 / $5,885.29	Facility		$680.86	$2,711.86	$5,885.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $497.03 / $680.86 / $6,973.54	Professional		$497.03	$680.86	$6,973.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,388.47 / $1,388.47 / $1,388.47	Professional		$1,388.47	$1,388.47	$1,388.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,388.47 / $1,388.47 / $1,388.47	Professional		$1,388.47	$1,388.47	$1,388.47
United Facility/Professional Facility Modifier Low / Median / High Price $0.87 / $572.62 / $616.42	Facility		$0.87	$572.62	$616.42
United Facility/Professional Professional Modifier Low / Median / High Price $461.80 / $692.69 / $1,327.66	Professional		$461.80	$692.69	$1,327.66