Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $894.71 / $894.71 / $894.71	Facility		$894.71	$894.71	$894.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $680.62 / $894.71 / $1,485.55	Professional		$680.62	$894.71	$1,485.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,773.59 / $1,950.95 / $3,227.93	Facility		$1,773.59	$1,950.95	$3,227.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,596.23 / $1,649.44 / $2,181.51	Professional		$1,596.23	$1,649.44	$2,181.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,275.92 / $3,795.48 / $3,795.48	Facility		$1,275.92	$3,795.48	$3,795.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,018.60 / $3,666.95 / $7,403.69	Facility		$1,018.60	$3,666.95	$7,403.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $743.58 / $2,953.85 / $3,356.65	Professional		$743.58	$2,953.85	$3,356.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $525.02 / $1,342.07 / $2,039.63	Facility		$525.02	$1,342.07	$2,039.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,015.53 / $1,693.83 / $2,128.31	Professional		$1,015.53	$1,693.83	$2,128.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $894.71 / $1,773.59 / $8,447.07	Facility		$894.71	$1,773.59	$8,447.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $824.18 / $1,185.08 / $2,000.74	Professional		$824.18	$1,185.08	$2,000.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,196.93	Professional		$50.00	$70.00	$1,196.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $525.02 / $1,342.07 / $2,039.63	Facility		$525.02	$1,342.07	$2,039.63
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,015.53 / $1,693.83 / $2,128.31	Professional		$1,015.53	$1,693.83	$2,128.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,773.59 / $2,729.51 / $4,879.99	Professional		$1,773.59	$2,729.51	$4,879.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,018.60 / $3,464.04 / $8,447.07	Facility		$1,018.60	$3,464.04	$8,447.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $743.58 / $1,018.60 / $10,758.78	Professional		$743.58	$1,018.60	$10,758.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,773.59 / $1,773.59 / $1,773.59	Professional		$1,773.59	$1,773.59	$1,773.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,773.59 / $1,773.59 / $1,773.59	Professional		$1,773.59	$1,773.59	$1,773.59
United Facility/Professional Professional Modifier Low / Median / High Price $677.71 / $1,084.33 / $1,773.59	Professional		$677.71	$1,084.33	$1,773.59