Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $692.78 / $692.78 / $692.78	Facility		$692.78	$692.78	$692.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $692.78 / $763.31 / $1,605.90	Professional		$692.78	$763.31	$1,605.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,373.30 / $1,510.63 / $2,499.41	Facility		$1,373.30	$1,510.63	$2,499.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,235.97 / $1,277.17 / $1,689.15	Professional		$1,235.97	$1,277.17	$1,689.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $987.95 / $2,938.86 / $2,938.86	Facility		$987.95	$2,938.86	$2,938.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $888.38 / $2,839.57 / $5,732.61	Facility		$888.38	$2,839.57	$5,732.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $648.52 / $1,990.31 / $2,599.08	Professional		$648.52	$1,990.31	$2,599.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $442.31 / $1,039.17 / $1,579.30	Facility		$442.31	$1,039.17	$1,579.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $786.32 / $1,373.30 / $1,709.29	Professional		$786.32	$1,373.30	$1,709.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $692.78 / $1,373.30 / $7,400.81	Facility		$692.78	$1,373.30	$7,400.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $622.09 / $799.31 / $1,550.44	Professional		$622.09	$799.31	$1,550.44
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 $442.31 / $1,039.17 / $1,579.30	Facility		$442.31	$1,039.17	$1,579.30
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $786.32 / $1,373.30 / $1,709.29	Professional		$786.32	$1,373.30	$1,709.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,373.30 / $2,113.46 / $4,111.16	Professional		$1,373.30	$2,113.46	$4,111.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $888.38 / $2,682.22 / $7,400.81	Facility		$888.38	$2,682.22	$7,400.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $648.52 / $888.38 / $8,204.59	Professional		$648.52	$888.38	$8,204.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,373.30 / $1,373.30 / $1,373.30	Professional		$1,373.30	$1,373.30	$1,373.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,373.30 / $1,373.30 / $1,373.30	Professional		$1,373.30	$1,373.30	$1,373.30
United Facility/Professional Professional Modifier Low / Median / High Price $547.11 / $750.58 / $1,313.15	Professional		$547.11	$750.58	$1,313.15