Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $678.85 / $678.85 / $678.85	Facility		$678.85	$678.85	$678.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $560.58 / $678.85 / $1,131.20	Professional		$560.58	$678.85	$1,131.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,345.68 / $1,480.25 / $2,449.14	Facility		$1,345.68	$1,480.25	$2,449.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,163.86 / $1,251.48 / $1,655.18	Professional		$1,163.86	$1,251.48	$1,655.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $968.08 / $2,879.76 / $2,879.76	Facility		$968.08	$2,879.76	$2,879.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $870.50 / $2,782.35 / $5,616.45	Facility		$870.50	$2,782.35	$5,616.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $635.47 / $1,950.00 / $2,546.80	Professional		$635.47	$1,950.00	$2,546.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $433.41 / $1,018.28 / $1,547.53	Facility		$433.41	$1,018.28	$1,547.53
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $770.50 / $1,345.68 / $1,794.25	Professional		$770.50	$1,345.68	$1,794.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $678.85 / $1,345.68 / $7,424.54	Facility		$678.85	$1,345.68	$7,424.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $625.69 / $899.15 / $1,519.25	Professional		$625.69	$899.15	$1,519.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $908.14	Professional		$50.00	$70.00	$908.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $433.41 / $1,038.64 / $1,547.53	Facility		$433.41	$1,038.64	$1,547.53
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $770.50 / $1,345.68 / $1,794.25	Professional		$770.50	$1,345.68	$1,794.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,345.68 / $2,070.96 / $4,027.85	Professional		$1,345.68	$2,070.96	$4,027.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $870.50 / $2,628.28 / $7,424.54	Facility		$870.50	$2,628.28	$7,424.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $635.47 / $870.50 / $10,101.42	Professional		$635.47	$870.50	$10,101.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,345.68 / $1,345.68 / $1,345.68	Professional		$1,345.68	$1,345.68	$1,345.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,345.68 / $1,345.68 / $1,345.68	Professional		$1,345.68	$1,345.68	$1,345.68
United Facility/Professional Professional Modifier Low / Median / High Price $559.46 / $807.41 / $1,154.13	Professional		$559.46	$807.41	$1,154.13