Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $581.45 / $581.45 / $581.45	Facility		$581.45	$581.45	$581.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $480.15 / $581.45 / $968.90	Professional		$480.15	$581.45	$968.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,152.61 / $1,267.88 / $2,097.77	Facility		$1,152.61	$1,267.88	$2,097.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,037.34 / $1,071.94 / $1,417.72	Professional		$1,037.34	$1,071.94	$1,417.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $829.19 / $2,466.61 / $2,466.61	Facility		$829.19	$2,466.61	$2,466.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.21 / $2,382.71 / $4,811.70	Facility		$812.21	$2,382.71	$4,811.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $592.91 / $1,670.16 / $2,181.44	Professional		$592.91	$1,670.16	$2,181.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $371.23 / $872.18 / $1,325.51	Facility		$371.23	$872.18	$1,325.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $659.96 / $1,152.61 / $1,536.83	Professional		$659.96	$1,152.61	$1,536.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $581.45 / $1,152.61 / $6,156.07	Facility		$581.45	$1,152.61	$6,156.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $535.91 / $770.15 / $1,301.30	Professional		$535.91	$770.15	$1,301.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $617.23	Professional		$50.00	$70.00	$617.23
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $371.23 / $889.62 / $1,325.51	Facility		$371.23	$889.62	$1,325.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $659.96 / $1,152.61 / $1,536.83	Professional		$659.96	$1,152.61	$1,536.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,152.61 / $1,773.85 / $3,450.72	Professional		$1,152.61	$1,773.85	$3,450.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $812.21 / $2,251.21 / $6,156.07	Facility		$812.21	$2,251.21	$6,156.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $592.91 / $812.21 / $8,214.44	Professional		$592.91	$812.21	$8,214.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,152.61 / $1,152.61 / $1,152.61	Professional		$1,152.61	$1,152.61	$1,152.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,152.61 / $1,152.61 / $1,152.61	Professional		$1,152.61	$1,152.61	$1,152.61
United Facility/Professional Professional Modifier Low / Median / High Price $459.19 / $691.57 / $1,152.61	Professional		$459.19	$691.57	$1,152.61