Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $593.27 / $593.27 / $593.27	Facility		$593.27	$593.27	$593.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.94 / $593.27 / $985.05	Professional		$398.94	$593.27	$985.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,176.04 / $1,293.64 / $2,140.39	Facility		$1,176.04	$1,293.64	$2,140.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,017.15 / $1,093.72 / $1,446.52	Professional		$1,017.15	$1,093.72	$1,446.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $846.04 / $2,516.73 / $2,516.73	Facility		$846.04	$2,516.73	$2,516.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $694.09 / $2,431.50 / $4,908.27	Facility		$694.09	$2,431.50	$4,908.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $506.69 / $1,704.38 / $2,225.75	Professional		$506.69	$1,704.38	$2,225.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $308.44 / $889.91 / $1,352.45	Facility		$308.44	$889.91	$1,352.45
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $673.38 / $1,084.04 / $1,411.25	Professional		$673.38	$1,084.04	$1,411.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $533.91 / $1,176.04 / $4,987.84	Facility		$533.91	$1,176.04	$4,987.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $484.19 / $719.69 / $1,280.57	Professional		$484.19	$719.69	$1,280.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $646.28	Professional		$50.00	$70.00	$646.28
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $308.44 / $889.91 / $1,352.45	Facility		$308.44	$889.91	$1,352.45
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $673.38 / $1,084.04 / $1,411.25	Professional		$673.38	$1,084.04	$1,411.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,176.04 / $1,809.90 / $2,866.57	Professional		$1,176.04	$1,809.90	$2,866.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $694.09 / $2,296.96 / $4,987.84	Facility		$694.09	$2,296.96	$4,987.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $506.69 / $694.09 / $6,358.86	Professional		$506.69	$694.09	$6,358.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,176.04 / $1,176.04 / $1,176.04	Professional		$1,176.04	$1,176.04	$1,176.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,176.04 / $1,176.04 / $1,176.04	Professional		$1,176.04	$1,176.04	$1,176.04
United Facility/Professional Professional Modifier Low / Median / High Price $398.14 / $705.62 / $1,176.04	Professional		$398.14	$705.62	$1,176.04