Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $430.95 / $709.29 / $815.68	Facility		$430.95	$709.29	$815.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $671.32 / $709.29 / $1,274.96	Professional		$671.32	$709.29	$1,274.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,406.03 / $1,546.63 / $2,558.96	Facility		$1,406.03	$1,546.63	$2,558.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,252.60 / $1,307.60 / $1,729.41	Professional		$1,252.60	$1,307.60	$1,729.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,011.50 / $3,008.90 / $3,008.90	Facility		$1,011.50	$3,008.90	$3,008.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $907.46 / $3,104.68 / $5,868.37	Facility		$907.46	$3,104.68	$5,868.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $907.46 / $1,646.43 / $2,661.03	Professional		$907.46	$1,646.43	$2,661.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $404.54 / $1,056.83 / $1,616.93	Facility		$404.54	$1,056.83	$1,616.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $805.06 / $1,372.31 / $1,687.24	Professional		$805.06	$1,372.31	$1,687.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $700.27 / $1,406.03 / $6,547.41	Facility		$700.27	$1,406.03	$6,547.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $613.96 / $736.53 / $1,530.99	Professional		$613.96	$736.53	$1,530.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $180.06	Professional		$50.00	$70.00	$180.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $404.54 / $1,063.94 / $1,616.93	Facility		$404.54	$1,063.94	$1,616.93
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $805.06 / $1,372.31 / $1,687.24	Professional		$805.06	$1,372.31	$1,687.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,406.03 / $2,163.85 / $3,759.86	Professional		$1,406.03	$2,163.85	$3,759.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $907.46 / $2,746.16 / $6,547.41	Facility		$907.46	$2,746.16	$6,547.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $662.45 / $907.46 / $7,078.87	Professional		$662.45	$907.46	$7,078.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,406.03 / $1,406.03 / $1,406.03	Professional		$1,406.03	$1,406.03	$1,406.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,406.03 / $1,406.03 / $1,406.03	Professional		$1,406.03	$1,406.03	$1,406.03
United Facility/Professional Professional Modifier Low / Median / High Price $522.19 / $701.45 / $1,406.03	Professional		$522.19	$701.45	$1,406.03