Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $653.85 / $653.85 / $653.85	Facility		$653.85	$653.85	$653.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $618.87 / $653.85 / $1,175.33	Professional		$618.87	$653.85	$1,175.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,296.14 / $1,425.75 / $2,358.96	Facility		$1,296.14	$1,425.75	$2,358.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,166.52 / $1,205.41 / $1,594.25	Professional		$1,166.52	$1,205.41	$1,594.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $932.44 / $2,773.74 / $2,773.74	Facility		$932.44	$2,773.74	$2,773.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $723.52 / $2,862.24 / $5,410.71	Facility		$723.52	$2,862.24	$5,410.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $528.16 / $1,878.28 / $2,453.04	Professional		$528.16	$1,878.28	$2,453.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $653.85 / $1,031.83 / $1,490.56	Facility		$653.85	$1,031.83	$1,490.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,265.07 / $1,296.14 / $1,555.37	Professional		$1,265.07	$1,296.14	$1,555.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $810.25 / $1,296.14 / $6,035.75	Facility		$810.25	$1,296.14	$6,035.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $578.60 / $687.12 / $1,418.78	Professional		$578.60	$687.12	$1,418.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $754.50	Professional		$50.00	$70.00	$754.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $653.85 / $1,036.91 / $1,490.56	Facility		$653.85	$1,036.91	$1,490.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,265.07 / $1,296.14 / $1,555.37	Professional		$1,265.07	$1,296.14	$1,555.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,296.14 / $1,994.72 / $3,465.78	Professional		$1,296.14	$1,994.72	$3,465.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $723.52 / $2,531.52 / $6,035.75	Facility		$723.52	$2,531.52	$6,035.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $528.16 / $723.52 / $6,525.74	Professional		$528.16	$723.52	$6,525.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,296.14 / $1,296.14 / $1,296.14	Professional		$1,296.14	$1,296.14	$1,296.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,296.14 / $1,296.14 / $1,296.14	Professional		$1,296.14	$1,296.14	$1,296.14
United Facility/Professional Professional Modifier Low / Median / High Price $481.38 / $667.61 / $1,239.36	Professional		$481.38	$667.61	$1,239.36