Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $975.21 / $975.21 / $975.21	Facility		$975.21	$975.21	$975.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $639.08 / $975.21 / $1,619.21	Professional		$639.08	$975.21	$1,619.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,933.16 / $2,126.48 / $3,518.35	Facility		$1,933.16	$2,126.48	$3,518.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,739.84 / $1,797.84 / $2,377.78	Professional		$1,739.84	$1,797.84	$2,377.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,390.72 / $4,136.96 / $4,136.96	Facility		$1,390.72	$4,136.96	$4,136.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $913.06 / $3,996.23 / $8,068.49	Facility		$913.06	$3,996.23	$8,068.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $666.53 / $2,801.25 / $3,658.65	Professional		$666.53	$2,801.25	$3,658.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $470.62 / $1,462.82 / $2,223.13	Facility		$470.62	$1,462.82	$2,223.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,106.86 / $1,619.33 / $2,319.79	Professional		$1,106.86	$1,619.33	$2,319.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $814.66 / $1,933.16 / $7,602.61	Facility		$814.66	$1,933.16	$7,602.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $842.51 / $1,098.35 / $2,104.96	Professional		$842.51	$1,098.35	$2,104.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $986.11	Professional		$50.00	$70.00	$986.11
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $470.62 / $1,462.82 / $2,223.13	Facility		$470.62	$1,462.82	$2,223.13
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,106.86 / $1,619.33 / $2,319.79	Professional		$1,106.86	$1,619.33	$2,319.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,933.16 / $2,899.74 / $4,374.12	Professional		$1,933.16	$2,899.74	$4,374.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $913.06 / $3,775.70 / $7,602.61	Facility		$913.06	$3,775.70	$7,602.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $666.53 / $913.06 / $9,088.15	Professional		$666.53	$913.06	$9,088.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,933.16 / $1,933.16 / $1,933.16	Professional		$1,933.16	$1,933.16	$1,933.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,933.16 / $1,933.16 / $1,933.16	Professional		$1,933.16	$1,933.16	$1,933.16
United Facility/Professional Professional Modifier Low / Median / High Price $658.87 / $1,097.02 / $1,933.16	Professional		$658.87	$1,097.02	$1,933.16