Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $561.29 / $561.29 / $561.29	Facility		$561.29	$561.29	$561.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.48 / $561.29 / $931.96	Professional		$455.48	$561.29	$931.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,112.67 / $1,223.94 / $2,025.06	Facility		$1,112.67	$1,223.94	$2,025.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,001.40 / $1,034.78 / $1,368.58	Professional		$1,001.40	$1,034.78	$1,368.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $800.44 / $2,381.11 / $2,381.11	Facility		$800.44	$2,381.11	$2,381.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $719.79 / $2,300.19 / $4,643.75	Facility		$719.79	$2,300.19	$4,643.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $525.45 / $1,612.50 / $2,105.81	Professional		$525.45	$1,612.50	$2,105.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $352.15 / $841.95 / $1,279.57	Facility		$352.15	$841.95	$1,279.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $637.10 / $1,112.67 / $1,457.85	Professional		$637.10	$1,112.67	$1,457.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $561.29 / $1,112.67 / $5,694.72	Facility		$561.29	$1,112.67	$5,694.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $517.35 / $743.47 / $1,256.21	Professional		$517.35	$743.47	$1,256.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $737.88	Professional		$50.00	$70.00	$737.88
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $352.15 / $850.15 / $1,279.57	Facility		$352.15	$850.15	$1,279.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $637.10 / $1,112.67 / $1,457.85	Professional		$637.10	$1,112.67	$1,457.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,112.67 / $1,712.35 / $3,273.07	Professional		$1,112.67	$1,712.35	$3,273.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $719.79 / $2,173.17 / $5,694.72	Facility		$719.79	$2,173.17	$5,694.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $525.45 / $719.79 / $7,260.09	Professional		$525.45	$719.79	$7,260.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,112.67 / $1,112.67 / $1,112.67	Professional		$1,112.67	$1,112.67	$1,112.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,112.67 / $1,112.67 / $1,112.67	Professional		$1,112.67	$1,112.67	$1,112.67
United Facility/Professional Professional Modifier Low / Median / High Price $454.57 / $740.13 / $1,211.55	Professional		$454.57	$740.13	$1,211.55