Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $682.58 / $682.58 / $682.58	Facility		$682.58	$682.58	$682.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $481.19 / $682.58 / $1,133.33	Professional		$481.19	$682.58	$1,133.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,353.09 / $1,488.40 / $2,462.62	Facility		$1,353.09	$1,488.40	$2,462.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.36 / $1,258.36 / $1,664.30	Professional		$1,258.36	$1,258.36	$1,664.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $973.41 / $2,895.61 / $2,895.61	Facility		$973.41	$2,895.61	$2,895.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.29 / $2,797.37 / $5,647.24	Facility		$875.29	$2,797.37	$5,647.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $638.96 / $1,960.78 / $2,560.84	Professional		$638.96	$1,960.78	$2,560.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $349.02 / $1,023.87 / $1,556.05	Facility		$349.02	$1,023.87	$1,556.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $774.74 / $1,302.31 / $1,623.71	Professional		$774.74	$1,302.31	$1,623.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $604.16 / $1,353.09 / $5,634.02	Facility		$604.16	$1,353.09	$5,634.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $609.50 / $814.38 / $1,473.35	Professional		$609.50	$814.38	$1,473.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $731.32	Professional		$50.00	$70.00	$731.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $349.02 / $1,023.87 / $1,556.05	Facility		$349.02	$1,023.87	$1,556.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $774.74 / $1,302.31 / $1,623.71	Professional		$774.74	$1,302.31	$1,623.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,353.09 / $2,068.29 / $3,243.96	Professional		$1,353.09	$2,068.29	$3,243.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $875.29 / $2,642.76 / $5,634.02	Facility		$875.29	$2,642.76	$5,634.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $638.96 / $875.29 / $6,301.80	Professional		$638.96	$875.29	$6,301.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,353.09 / $1,353.09 / $1,353.09	Professional		$1,353.09	$1,353.09	$1,353.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,353.09 / $1,353.09 / $1,353.09	Professional		$1,353.09	$1,353.09	$1,353.09
United Facility/Professional Professional Modifier Low / Median / High Price $450.03 / $720.84 / $1,160.48	Professional		$450.03	$720.84	$1,160.48