Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $866.03 / $866.03 / $866.03	Facility		$866.03	$866.03	$866.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $600.45 / $866.03 / $1,437.93	Professional		$600.45	$866.03	$1,437.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,716.73 / $1,888.40 / $3,124.45	Facility		$1,716.73	$1,888.40	$3,124.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,545.05 / $1,596.56 / $2,111.57	Professional		$1,545.05	$1,596.56	$2,111.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,235.02 / $3,673.80 / $3,673.80	Facility		$1,235.02	$3,673.80	$3,673.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,200.11 / $3,548.77 / $7,165.77	Facility		$1,200.11	$3,548.77	$7,165.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $876.09 / $2,487.66 / $3,249.04	Professional		$876.09	$2,487.66	$3,249.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $464.23 / $1,299.05 / $1,974.24	Facility		$464.23	$1,299.05	$1,974.24
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $982.97 / $1,441.39 / $2,060.08	Professional		$982.97	$1,441.39	$2,060.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $803.61 / $1,716.73 / $7,578.14	Facility		$803.61	$1,716.73	$7,578.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $728.76 / $1,083.21 / $1,869.31	Professional		$728.76	$1,083.21	$1,869.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $972.73	Professional		$50.00	$70.00	$972.73
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $464.23 / $1,299.05 / $1,974.24	Facility		$464.23	$1,299.05	$1,974.24
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $982.97 / $1,441.39 / $2,060.08	Professional		$982.97	$1,441.39	$2,060.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,716.73 / $2,642.00 / $4,314.91	Professional		$1,716.73	$2,642.00	$4,314.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,200.11 / $3,352.98 / $7,578.14	Facility		$1,200.11	$3,352.98	$7,578.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $876.09 / $1,200.11 / $9,570.81	Professional		$876.09	$1,200.11	$9,570.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,716.73 / $1,716.73 / $1,716.73	Professional		$1,716.73	$1,716.73	$1,716.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,716.73 / $1,716.73 / $1,716.73	Professional		$1,716.73	$1,716.73	$1,716.73
United Facility/Professional Professional Modifier Low / Median / High Price $599.25 / $958.79 / $1,492.01	Professional		$599.25	$958.79	$1,492.01