Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $929.38 / $929.38 / $929.38	Facility		$929.38	$929.38	$929.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $879.64 / $929.38 / $1,670.58	Professional		$879.64	$929.38	$1,670.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,842.32 / $2,026.55 / $3,353.02	Facility		$1,842.32	$2,026.55	$3,353.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,694.15 / $1,713.36 / $2,266.05	Professional		$1,694.15	$1,713.36	$2,266.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,325.36 / $3,942.56 / $3,942.56	Facility		$1,325.36	$3,942.56	$3,942.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,028.38 / $4,067.45 / $7,690.60	Facility		$1,028.38	$4,067.45	$7,690.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $750.72 / $2,712.24 / $3,486.74	Professional		$750.72	$2,712.24	$3,486.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $530.05 / $1,394.07 / $2,118.67	Facility		$530.05	$1,394.07	$2,118.67
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,054.85 / $1,798.13 / $2,210.78	Professional		$1,054.85	$1,798.13	$2,210.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $917.56 / $1,842.32 / $8,579.00	Facility		$917.56	$1,842.32	$8,579.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $804.47 / $965.07 / $2,006.06	Professional		$804.47	$965.07	$2,006.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,214.56	Professional		$50.00	$70.00	$1,214.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $530.05 / $1,394.07 / $2,118.67	Facility		$530.05	$1,394.07	$2,118.67
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,054.85 / $1,798.13 / $2,210.78	Professional		$1,054.85	$1,798.13	$2,210.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,842.32 / $2,835.29 / $4,926.16	Professional		$1,842.32	$2,835.29	$4,926.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,028.38 / $3,598.28 / $8,579.00	Facility		$1,028.38	$3,598.28	$8,579.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $750.72 / $1,028.38 / $9,275.29	Professional		$750.72	$1,028.38	$9,275.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,842.32 / $1,842.32 / $1,842.32	Professional		$1,842.32	$1,842.32	$1,842.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,842.32 / $1,842.32 / $1,842.32	Professional		$1,842.32	$1,842.32	$1,842.32
United Facility/Professional Professional Modifier Low / Median / High Price $684.22 / $919.12 / $1,755.50	Professional		$684.22	$919.12	$1,755.50