Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $594.36 / $594.36 / $594.36	Facility		$594.36	$594.36	$594.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $560.26 / $594.36 / $1,064.03	Professional		$560.26	$594.36	$1,064.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,178.21 / $1,296.03 / $2,144.34	Facility		$1,178.21	$1,296.03	$2,144.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,019.03 / $1,095.74 / $1,449.19	Professional		$1,019.03	$1,095.74	$1,449.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $847.60 / $2,521.37 / $2,521.37	Facility		$847.60	$2,521.37	$2,521.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.22 / $2,436.19 / $4,918.07	Facility		$736.22	$2,436.19	$4,918.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.44 / $1,707.19 / $2,229.86	Professional		$537.44	$1,707.19	$2,229.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $379.47 / $891.54 / $1,354.94	Facility		$379.47	$891.54	$1,354.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $674.62 / $1,178.21 / $1,570.95	Professional		$674.62	$1,178.21	$1,570.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $594.36 / $1,178.21 / $6,310.18	Facility		$594.36	$1,178.21	$6,310.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $533.72 / $685.76 / $1,330.18	Professional		$533.72	$685.76	$1,330.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $371.18	Professional		$50.00	$70.00	$371.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $379.47 / $891.54 / $1,354.94	Facility		$379.47	$891.54	$1,354.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $674.62 / $1,178.21 / $1,570.95	Professional		$674.62	$1,178.21	$1,570.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,178.21 / $1,813.21 / $3,527.00	Professional		$1,178.21	$1,813.21	$3,527.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $736.22 / $2,301.19 / $6,310.18	Facility		$736.22	$2,301.19	$6,310.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $537.44 / $736.22 / $9,966.95	Professional		$537.44	$736.22	$9,966.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,178.21 / $1,178.21 / $1,178.21	Professional		$1,178.21	$1,178.21	$1,178.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $940.77 / $1,178.21 / $1,178.21	Professional		$940.77	$1,178.21	$1,178.21
United Facility/Professional Professional Modifier Low / Median / High Price $469.38 / $624.46 / $1,140.69	Professional		$469.38	$624.46	$1,140.69