Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $654.87 / $654.87 / $654.87	Facility		$654.87	$654.87	$654.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $543.69 / $654.87 / $1,097.13	Professional		$543.69	$654.87	$1,097.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,298.16 / $1,427.98 / $2,362.65	Facility		$1,298.16	$1,427.98	$2,362.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,168.33 / $1,207.29 / $1,596.73	Professional		$1,168.33	$1,207.29	$1,596.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $933.89 / $2,778.06 / $2,778.06	Facility		$933.89	$2,778.06	$2,778.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.63 / $2,866.24 / $5,419.11	Facility		$724.63	$2,866.24	$5,419.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $528.98 / $1,881.09 / $2,456.86	Professional		$528.98	$1,881.09	$2,456.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $373.50 / $982.31 / $1,492.88	Facility		$373.50	$982.31	$1,492.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $743.30 / $1,267.04 / $1,557.79	Professional		$743.30	$1,267.04	$1,557.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $646.54 / $1,298.16 / $6,045.06	Facility		$646.54	$1,298.16	$6,045.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $592.76 / $867.39 / $1,413.53	Professional		$592.76	$867.39	$1,413.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $876.06	Professional		$50.00	$70.00	$876.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $373.50 / $982.31 / $1,492.88	Facility		$373.50	$982.31	$1,492.88
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $743.30 / $1,267.04 / $1,557.79	Professional		$743.30	$1,267.04	$1,557.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,298.16 / $1,997.81 / $3,471.80	Professional		$1,298.16	$1,997.81	$3,471.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $724.63 / $2,535.46 / $6,045.06	Facility		$724.63	$2,535.46	$6,045.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $528.98 / $724.63 / $6,535.45	Professional		$528.98	$724.63	$6,535.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,298.16 / $1,298.16 / $1,298.16	Professional		$1,298.16	$1,298.16	$1,298.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,036.56 / $1,298.16 / $1,298.16	Professional		$1,036.56	$1,298.16	$1,298.16
United Facility/Professional Professional Modifier Low / Median / High Price $517.16 / $863.51 / $1,298.16	Professional		$517.16	$863.51	$1,298.16