Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $896.09 / $896.09 / $896.09	Facility		$896.09	$896.09	$896.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $800.95 / $896.09 / $1,553.30	Professional		$800.95	$896.09	$1,553.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,776.32 / $1,953.95 / $3,232.90	Facility		$1,776.32	$1,953.95	$3,232.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,651.98 / $1,651.98 / $2,184.87	Professional		$1,651.98	$1,651.98	$2,184.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,277.88 / $3,801.32 / $3,801.32	Facility		$1,277.88	$3,801.32	$3,801.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.35 / $3,672.59 / $7,414.89	Facility		$891.35	$3,672.59	$7,414.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.35 / $2,079.71 / $3,361.83	Professional		$891.35	$2,079.71	$3,361.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $459.43 / $1,344.14 / $2,042.77	Facility		$459.43	$1,344.14	$2,042.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,017.07 / $1,746.47 / $2,131.58	Professional		$1,017.07	$1,746.47	$2,131.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $795.30 / $1,776.32 / $7,437.46	Facility		$795.30	$1,776.32	$7,437.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $707.67 / $886.19 / $1,934.20	Professional		$707.67	$886.19	$1,934.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,204.17	Professional		$50.00	$70.00	$1,204.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $459.43 / $1,344.14 / $2,042.77	Facility		$459.43	$1,344.14	$2,042.77
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,017.07 / $1,746.47 / $2,131.58	Professional		$1,017.07	$1,746.47	$2,131.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,776.32 / $2,664.48 / $4,269.74	Professional		$1,776.32	$2,664.48	$4,269.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $891.35 / $3,469.38 / $7,437.46	Facility		$891.35	$3,469.38	$7,437.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $650.69 / $891.35 / $8,383.06	Professional		$650.69	$891.35	$8,383.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,776.32 / $1,776.32 / $1,776.32	Professional		$1,776.32	$1,776.32	$1,776.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,418.34 / $1,776.32 / $1,776.32	Professional		$1,418.34	$1,776.32	$1,776.32
United Facility/Professional Professional Modifier Low / Median / High Price $590.79 / $886.19 / $1,698.53	Professional		$590.79	$886.19	$1,698.53