Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $548.55 / $548.55 / $548.55	Facility		$548.55	$548.55	$548.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $519.21 / $558.91 / $976.51	Professional		$519.21	$558.91	$976.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,087.41 / $1,196.15 / $1,979.09	Facility		$1,087.41	$1,196.15	$1,979.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $978.66 / $1,011.29 / $1,337.51	Professional		$978.66	$1,011.29	$1,337.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $782.27 / $2,327.06 / $2,327.06	Facility		$782.27	$2,327.06	$2,327.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $607.01 / $2,401.40 / $4,538.79	Facility		$607.01	$2,401.40	$4,538.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $607.00 / $1,273.35 / $2,058.00	Professional		$607.00	$1,273.35	$2,058.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $312.88 / $822.84 / $1,250.52	Facility		$312.88	$822.84	$1,250.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $622.63 / $1,061.39 / $1,304.89	Professional		$622.63	$1,061.39	$1,304.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $541.60 / $1,087.41 / $5,063.85	Facility		$541.60	$1,087.41	$5,063.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $433.21 / $542.50 / $1,184.05	Professional		$433.21	$542.50	$1,184.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $454.20	Professional		$50.00	$70.00	$454.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $312.88 / $822.84 / $1,250.52	Facility		$312.88	$822.84	$1,250.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $622.63 / $1,061.39 / $1,304.89	Professional		$622.63	$1,061.39	$1,304.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,087.41 / $1,673.49 / $2,907.72	Professional		$1,087.41	$1,673.49	$2,907.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $607.01 / $2,123.84 / $5,063.85	Facility		$607.01	$2,123.84	$5,063.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $443.12 / $607.01 / $5,474.86	Professional		$443.12	$607.01	$5,474.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,087.41 / $1,087.41 / $1,087.41	Professional		$1,087.41	$1,087.41	$1,087.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $868.28 / $1,087.41 / $1,087.41	Professional		$868.28	$1,087.41	$1,087.41
United Facility/Professional Professional Modifier Low / Median / High Price $379.47 / $542.50 / $1,087.41	Professional		$379.47	$542.50	$1,087.41