Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.91 / $524.91 / $524.91	Facility		$524.91	$524.91	$524.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $364.41 / $524.91 / $871.56	Professional		$364.41	$524.91	$871.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,040.55 / $1,144.60 / $1,893.80	Facility		$1,040.55	$1,144.60	$1,893.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $936.49 / $967.71 / $1,279.86	Professional		$936.49	$967.71	$1,279.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $748.57 / $2,226.78 / $2,226.78	Facility		$748.57	$2,226.78	$2,226.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $673.11 / $2,151.02 / $4,342.85	Facility		$673.11	$2,151.02	$4,342.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $491.37 / $1,507.97 / $1,969.31	Professional		$491.37	$1,507.97	$1,969.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $281.75 / $787.38 / $1,196.63	Facility		$281.75	$787.38	$1,196.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $595.79 / $1,040.55 / $1,248.66	Professional		$595.79	$1,040.55	$1,248.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $487.71 / $1,040.55 / $4,663.25	Facility		$487.71	$1,040.55	$4,663.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $468.72 / $657.41 / $1,133.03	Professional		$468.72	$657.41	$1,133.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $702.23	Professional		$50.00	$70.00	$702.23
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $281.75 / $787.38 / $1,196.63	Facility		$281.75	$787.38	$1,196.63
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $595.79 / $1,040.55 / $1,248.66	Professional		$595.79	$1,040.55	$1,248.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,040.55 / $1,601.35 / $2,618.65	Professional		$1,040.55	$1,601.35	$2,618.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $673.11 / $2,032.32 / $4,663.25	Facility		$673.11	$2,032.32	$4,663.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $491.37 / $673.11 / $6,154.20	Professional		$491.37	$673.11	$6,154.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,040.55 / $1,040.55 / $1,040.55	Professional		$1,040.55	$1,040.55	$1,040.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,040.55 / $1,040.55 / $1,040.55	Professional		$1,040.55	$1,040.55	$1,040.55
United Facility/Professional Professional Modifier Low / Median / High Price $414.54 / $581.89 / $1,040.55	Professional		$414.54	$581.89	$1,040.55