Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $556.79 / $556.79 / $556.79	Facility		$556.79	$556.79	$556.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $526.99 / $556.79 / $1,000.85	Professional		$526.99	$556.79	$1,000.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,103.73 / $1,214.09 / $2,008.79	Facility		$1,103.73	$1,214.09	$2,008.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,026.47 / $1,026.47 / $1,357.58	Professional		$1,026.47	$1,026.47	$1,357.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $794.02 / $2,361.98 / $2,361.98	Facility		$794.02	$2,361.98	$2,361.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.27 / $2,333.28 / $4,607.35	Facility		$616.27	$2,333.28	$4,607.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $449.88 / $1,599.38 / $2,088.89	Professional		$449.88	$1,599.38	$2,088.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $556.79 / $878.64 / $1,269.29	Facility		$556.79	$878.64	$1,269.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,077.28 / $1,103.73 / $1,324.48	Professional		$1,077.28	$1,103.73	$1,324.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $689.95 / $1,103.73 / $5,140.93	Facility		$689.95	$1,103.73	$5,140.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $509.26 / $587.61 / $1,230.06	Professional		$509.26	$587.61	$1,230.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $556.79 / $882.98 / $1,269.29	Facility		$556.79	$882.98	$1,269.29
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,077.28 / $1,103.73 / $1,324.48	Professional		$1,077.28	$1,103.73	$1,324.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,103.73 / $1,698.59 / $2,951.88	Professional		$1,103.73	$1,698.59	$2,951.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $616.27 / $2,155.71 / $5,140.93	Facility		$616.27	$2,155.71	$5,140.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $449.88 / $616.27 / $5,568.19	Professional		$449.88	$616.27	$5,568.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,103.73 / $1,103.73 / $1,103.73	Professional		$1,103.73	$1,103.73	$1,103.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,103.73 / $1,103.73 / $1,103.73	Professional		$1,103.73	$1,103.73	$1,103.73
United Facility/Professional Professional Modifier Low / Median / High Price $391.74 / $573.01 / $1,055.39	Professional		$391.74	$573.01	$1,055.39