Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $650.09 / $650.09 / $650.09	Facility		$650.09	$650.09	$650.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $650.09 / $715.78 / $1,444.38	Professional		$650.09	$715.78	$1,444.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,288.69 / $1,417.56 / $2,345.42	Facility		$1,288.69	$1,417.56	$2,345.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,114.58 / $1,198.48 / $1,585.08	Professional		$1,114.58	$1,198.48	$1,585.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $927.08 / $2,757.80 / $2,757.80	Facility		$927.08	$2,757.80	$2,757.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $908.11 / $2,664.16 / $5,378.52	Facility		$908.11	$2,664.16	$5,378.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $662.92 / $2,146.27 / $2,438.94	Professional		$662.92	$2,146.27	$2,438.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $415.05 / $975.14 / $1,481.99	Facility		$415.05	$975.14	$1,481.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $737.87 / $1,288.69 / $1,546.43	Professional		$737.87	$1,288.69	$1,546.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $650.09 / $1,288.69 / $6,807.72	Facility		$650.09	$1,288.69	$6,807.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $599.17 / $861.07 / $1,417.56	Professional		$599.17	$861.07	$1,417.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $876.46	Professional		$50.00	$70.00	$876.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $415.05 / $994.64 / $1,481.99	Facility		$415.05	$994.64	$1,481.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $737.87 / $1,288.69 / $1,546.43	Professional		$737.87	$1,288.69	$1,546.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,288.69 / $1,983.23 / $3,857.22	Professional		$1,288.69	$1,983.23	$3,857.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $908.11 / $2,516.96 / $6,807.72	Facility		$908.11	$2,516.96	$6,807.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $662.92 / $908.11 / $8,505.34	Professional		$662.92	$908.11	$8,505.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,288.69 / $1,288.69 / $1,288.69	Professional		$1,288.69	$1,288.69	$1,288.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,288.69 / $1,288.69 / $1,288.69	Professional		$1,288.69	$1,288.69	$1,288.69
United Facility/Professional Facility Modifier Low / Median / High Price $2,061.90 / $2,061.90 / $2,061.90	Facility		$2,061.90	$2,061.90	$2,061.90
United Facility/Professional Professional Modifier Low / Median / High Price $535.76 / $857.22 / $1,105.24	Professional		$535.76	$857.22	$1,105.24