Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $898.06 / $898.06 / $898.06	Facility		$898.06	$898.06	$898.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $642.15 / $898.06 / $1,491.12	Professional		$642.15	$898.06	$1,491.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,780.23 / $1,958.25 / $3,240.02	Facility		$1,780.23	$1,958.25	$3,240.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,655.61 / $1,655.61 / $2,189.67	Professional		$1,655.61	$1,655.61	$2,189.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,280.69 / $3,809.69 / $3,809.69	Facility		$1,280.69	$3,809.69	$3,809.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $963.22 / $3,680.08 / $7,430.29	Facility		$963.22	$3,680.08	$7,430.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $703.15 / $2,580.00 / $3,369.24	Professional		$703.15	$2,580.00	$3,369.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $496.48 / $1,347.09 / $2,047.26	Facility		$496.48	$1,347.09	$2,047.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,019.32 / $1,780.23 / $2,136.28	Professional		$1,019.32	$1,780.23	$2,136.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $859.42 / $1,780.23 / $8,261.60	Facility		$859.42	$1,780.23	$8,261.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $801.91 / $1,158.45 / $1,938.45	Professional		$801.91	$1,158.45	$1,938.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,040.29	Professional		$50.00	$70.00	$1,040.29
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $496.48 / $1,347.09 / $2,047.26	Facility		$496.48	$1,347.09	$2,047.26
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,019.32 / $1,780.23 / $2,136.28	Professional		$1,019.32	$1,780.23	$2,136.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,780.23 / $2,739.73 / $4,614.01	Professional		$1,780.23	$2,739.73	$4,614.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $963.22 / $3,477.02 / $8,261.60	Facility		$963.22	$3,477.02	$8,261.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $703.15 / $963.23 / $10,112.74	Professional		$703.15	$963.23	$10,112.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,780.23 / $1,780.23 / $1,780.23	Professional		$1,780.23	$1,780.23	$1,780.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,780.23 / $1,780.23 / $1,780.23	Professional		$1,780.23	$1,780.23	$1,780.23
United Facility/Professional Professional Modifier Low / Median / High Price $695.07 / $1,158.71 / $1,780.23	Professional		$695.07	$1,158.71	$1,780.23