Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $975.53 / $975.53 / $975.53	Facility		$975.53	$975.53	$975.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $805.57 / $975.53 / $1,625.57	Professional		$805.57	$975.53	$1,625.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,933.80 / $2,127.17 / $3,519.52	Facility		$1,933.80	$2,127.17	$3,519.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,672.53 / $1,798.43 / $2,378.57	Professional		$1,672.53	$1,798.43	$2,378.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,391.17 / $4,138.33 / $4,138.33	Facility		$1,391.17	$4,138.33	$4,138.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,226.77 / $3,998.10 / $8,071.29	Facility		$1,226.77	$3,998.10	$8,071.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $895.54 / $2,802.19 / $3,659.88	Professional		$895.54	$2,802.19	$3,659.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $622.83 / $1,463.30 / $2,223.87	Facility		$622.83	$1,463.30	$2,223.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,107.25 / $1,933.80 / $2,378.61	Professional		$1,107.25	$1,933.80	$2,378.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $975.53 / $1,933.80 / $10,120.69	Facility		$975.53	$1,933.80	$10,120.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $899.12 / $1,292.10 / $2,183.23	Professional		$899.12	$1,292.10	$2,183.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,305.03	Professional		$50.00	$70.00	$1,305.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $622.83 / $1,492.56 / $2,223.87	Facility		$622.83	$1,492.56	$2,223.87
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,107.25 / $1,933.80 / $2,378.61	Professional		$1,107.25	$1,933.80	$2,378.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,933.80 / $2,976.07 / $5,788.34	Professional		$1,933.80	$2,976.07	$5,788.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,226.77 / $3,776.96 / $10,120.69	Facility		$1,226.77	$3,776.96	$10,120.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $895.54 / $1,226.77 / $12,840.43	Professional		$895.54	$1,226.77	$12,840.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,933.80 / $1,933.80 / $1,933.80	Professional		$1,933.80	$1,933.80	$1,933.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,933.80 / $1,933.80 / $1,933.80	Professional		$1,933.80	$1,933.80	$1,933.80
United Facility/Professional Professional Modifier Low / Median / High Price $803.96 / $1,286.33 / $1,714.54	Professional		$803.96	$1,286.33	$1,714.54