Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $808.16 / $808.16 / $808.16	Facility		$808.16	$808.16	$808.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $572.44 / $808.16 / $1,341.85	Professional		$572.44	$808.16	$1,341.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,602.03 / $1,762.23 / $2,915.69	Facility		$1,602.03	$1,762.23	$2,915.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,489.89 / $1,489.89 / $1,970.49	Professional		$1,489.89	$1,489.89	$1,970.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,152.50 / $3,428.34 / $3,428.34	Facility		$1,152.50	$3,428.34	$3,428.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,036.33 / $3,312.38 / $6,687.12	Facility		$1,036.33	$3,312.38	$6,687.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $756.53 / $2,321.71 / $3,031.96	Professional		$756.53	$2,321.71	$3,031.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $442.58 / $1,212.24 / $1,842.33	Facility		$442.58	$1,212.24	$1,842.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $917.29 / $1,602.03 / $1,922.44	Professional		$917.29	$1,602.03	$1,922.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $766.13 / $1,602.03 / $7,109.86	Facility		$766.13	$1,602.03	$7,109.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $721.64 / $1,032.69 / $1,744.41	Professional		$721.64	$1,032.69	$1,744.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $927.36	Professional		$50.00	$70.00	$927.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $442.58 / $1,212.24 / $1,842.33	Facility		$442.58	$1,212.24	$1,842.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $917.29 / $1,602.03 / $1,922.44	Professional		$917.29	$1,602.03	$1,922.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,602.03 / $2,465.48 / $4,113.16	Professional		$1,602.03	$2,465.48	$4,113.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,036.33 / $3,128.96 / $7,109.86	Facility		$1,036.33	$3,128.96	$7,109.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $756.53 / $1,036.33 / $9,440.37	Professional		$756.53	$1,036.33	$9,440.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,602.03 / $1,602.03 / $1,602.03	Professional		$1,602.03	$1,602.03	$1,602.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,602.03 / $1,602.03 / $1,602.03	Professional		$1,602.03	$1,602.03	$1,602.03
United Facility/Professional Professional Modifier Low / Median / High Price $596.82 / $1,021.17 / $1,602.03	Professional		$596.82	$1,021.17	$1,602.03