Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $801.07 / $801.07 / $801.07	Facility		$801.07	$801.07	$801.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $665.09 / $801.07 / $1,342.10	Professional		$665.09	$801.07	$1,342.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,587.98 / $1,746.78 / $2,890.12	Facility		$1,587.98	$1,746.78	$2,890.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,476.82 / $1,476.82 / $1,953.21	Professional		$1,476.82	$1,476.82	$1,953.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,142.39 / $3,398.28 / $3,398.28	Facility		$1,142.39	$3,398.28	$3,398.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $886.63 / $3,506.43 / $6,628.34	Facility		$886.63	$3,506.43	$6,628.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $647.24 / $2,301.09 / $3,005.38	Professional		$647.24	$2,301.09	$3,005.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $457.00 / $1,201.60 / $1,826.18	Facility		$457.00	$1,201.60	$1,826.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $909.23 / $1,549.90 / $1,905.58	Professional		$909.23	$1,549.90	$1,905.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $791.08 / $1,587.98 / $7,396.37	Facility		$791.08	$1,587.98	$7,396.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $725.28 / $1,061.04 / $1,729.11	Professional		$725.28	$1,061.04	$1,729.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $957.56	Professional		$50.00	$70.00	$957.56
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $457.00 / $1,201.60 / $1,826.18	Facility		$457.00	$1,201.60	$1,826.18
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $909.23 / $1,549.90 / $1,905.58	Professional		$909.23	$1,549.90	$1,905.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,587.98 / $2,443.85 / $4,247.66	Professional		$1,587.98	$2,443.85	$4,247.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $886.63 / $3,101.52 / $7,396.37	Facility		$886.63	$3,101.52	$7,396.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $647.24 / $886.63 / $8,010.83	Professional		$647.24	$886.63	$8,010.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,587.98 / $1,587.98 / $1,587.98	Professional		$1,587.98	$1,587.98	$1,587.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,587.98 / $1,587.98 / $1,587.98	Professional		$1,587.98	$1,587.98	$1,587.98
United Facility/Professional Professional Modifier Low / Median / High Price $589.91 / $952.79 / $1,587.98	Professional		$589.91	$952.79	$1,587.98