Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $766.52 / $766.52 / $766.52	Facility		$766.52	$766.52	$766.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $632.70 / $766.52 / $1,201.60	Professional		$632.70	$766.52	$1,201.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,519.47 / $1,671.42 / $2,765.44	Facility		$1,519.47	$1,671.42	$2,765.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,314.19 / $1,413.11 / $1,868.94	Professional		$1,314.19	$1,413.11	$1,868.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,093.10 / $3,251.67 / $3,251.67	Facility		$1,093.10	$3,251.67	$3,251.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $832.50 / $3,141.63 / $6,342.82	Facility		$832.50	$3,141.63	$6,342.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $607.73 / $2,201.71 / $2,875.73	Professional		$607.73	$2,201.71	$2,875.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $429.10 / $1,149.78 / $1,747.39	Facility		$429.10	$1,149.78	$1,747.39
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $870.01 / $1,519.47 / $1,823.36	Professional		$870.01	$1,519.47	$1,823.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $742.79 / $1,519.47 / $7,134.94	Facility		$742.79	$1,519.47	$7,134.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $614.54 / $790.63 / $1,661.69	Professional		$614.54	$790.63	$1,661.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,008.57	Professional		$50.00	$70.00	$1,008.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $429.10 / $1,149.78 / $1,747.39	Facility		$429.10	$1,149.78	$1,747.39
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $870.01 / $1,519.47 / $1,823.36	Professional		$870.01	$1,519.47	$1,823.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,519.47 / $2,338.42 / $3,987.70	Professional		$1,519.47	$2,338.42	$3,987.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $832.50 / $2,967.72 / $7,134.94	Facility		$832.50	$2,967.72	$7,134.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $607.73 / $832.50 / $9,077.27	Professional		$607.73	$832.50	$9,077.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,519.47 / $1,519.47 / $1,519.47	Professional		$1,519.47	$1,519.47	$1,519.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,519.47 / $1,519.47 / $1,519.47	Professional		$1,519.47	$1,519.47	$1,519.47
United Facility/Professional Professional Modifier Low / Median / High Price $603.52 / $758.05 / $1,519.47	Professional		$603.52	$758.05	$1,519.47