Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $751.09 / $751.09 / $751.09	Facility		$751.09	$751.09	$751.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $710.89 / $751.09 / $1,350.10	Professional		$710.89	$751.09	$1,350.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,488.90 / $1,637.79 / $2,709.80	Facility		$1,488.90	$1,637.79	$2,709.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,326.44 / $1,384.68 / $1,831.34	Professional		$1,326.44	$1,384.68	$1,831.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,071.10 / $3,186.25 / $3,186.25	Facility		$1,071.10	$3,186.25	$3,186.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $831.10 / $3,287.02 / $6,215.46	Facility		$831.10	$3,287.02	$6,215.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $831.10 / $1,743.39 / $2,817.85	Professional		$831.10	$1,743.39	$2,817.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $428.38 / $1,126.64 / $1,712.24	Facility		$428.38	$1,126.64	$1,712.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $852.50 / $1,453.18 / $1,786.68	Professional		$852.50	$1,453.18	$1,786.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $741.54 / $1,488.90 / $6,933.23	Facility		$741.54	$1,488.90	$6,933.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $650.14 / $779.93 / $1,621.22	Professional		$650.14	$779.93	$1,621.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $981.56	Professional		$50.00	$70.00	$981.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $428.38 / $1,126.64 / $1,712.24	Facility		$428.38	$1,126.64	$1,712.24
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $852.50 / $1,453.18 / $1,786.68	Professional		$852.50	$1,453.18	$1,786.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,488.90 / $2,291.38 / $3,981.68	Professional		$1,488.90	$2,291.38	$3,981.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $831.10 / $2,908.00 / $6,933.23	Facility		$831.10	$2,908.00	$6,933.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $606.70 / $831.10 / $7,495.95	Professional		$606.70	$831.10	$7,495.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,488.90 / $1,488.90 / $1,488.90	Professional		$1,488.90	$1,488.90	$1,488.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,488.90 / $1,488.90 / $1,488.90	Professional		$1,488.90	$1,488.90	$1,488.90
United Facility/Professional Professional Modifier Low / Median / High Price $519.54 / $742.79 / $1,423.69	Professional		$519.54	$742.79	$1,423.69