Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $586.42 / $586.42 / $586.42	Facility		$586.42	$586.42	$586.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $490.59 / $586.42 / $931.71	Professional		$490.59	$586.42	$931.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,162.49 / $1,278.74 / $2,115.73	Facility		$1,162.49	$1,278.74	$2,115.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,081.11 / $1,081.11 / $1,429.86	Professional		$1,081.11	$1,081.11	$1,429.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $836.30 / $2,487.73 / $2,487.73	Facility		$836.30	$2,487.73	$2,487.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $751.98 / $2,403.37 / $4,852.29	Facility		$751.98	$2,403.37	$4,852.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $548.95 / $1,936.09 / $2,200.10	Professional		$548.95	$1,936.09	$2,200.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $312.52 / $879.65 / $1,336.86	Facility		$312.52	$879.65	$1,336.86
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $665.60 / $1,162.49 / $1,394.99	Professional		$665.60	$1,162.49	$1,394.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $541.00 / $1,162.49 / $5,145.80	Facility		$541.00	$1,162.49	$5,145.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $463.12 / $579.95 / $1,265.80	Professional		$463.12	$579.95	$1,265.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $838.28	Professional		$50.00	$70.00	$838.28
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $312.52 / $879.65 / $1,336.86	Facility		$312.52	$879.65	$1,336.86
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $665.60 / $1,162.49 / $1,394.99	Professional		$665.60	$1,162.49	$1,394.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,162.49 / $1,789.05 / $2,904.71	Professional		$1,162.49	$1,789.05	$2,904.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $751.98 / $2,270.48 / $5,145.80	Facility		$751.98	$2,270.48	$5,145.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $548.95 / $751.98 / $6,210.34	Professional		$548.95	$751.98	$6,210.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,162.49 / $1,162.49 / $1,162.49	Professional		$1,162.49	$1,162.49	$1,162.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,162.49 / $1,162.49 / $1,162.49	Professional		$1,162.49	$1,162.49	$1,162.49
United Facility/Professional Facility Modifier Low / Median / High Price $0.77 / $479.78 / $633.41	Facility		$0.77	$479.78	$633.41
United Facility/Professional Professional Modifier Low / Median / High Price $386.64 / $579.95 / $1,111.58	Professional		$386.64	$579.95	$1,111.58