Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $879.40 / $879.40 / $879.40	Facility		$879.40	$879.40	$879.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $596.66 / $879.40 / $1,460.14	Professional		$596.66	$879.40	$1,460.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,743.25 / $1,917.58 / $3,172.72	Facility		$1,743.25	$1,917.58	$3,172.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,568.92 / $1,621.22 / $2,144.19	Professional		$1,568.92	$1,621.22	$2,144.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,254.08 / $3,730.56 / $3,730.56	Facility		$1,254.08	$3,730.56	$3,730.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $895.00 / $3,604.10 / $7,276.33	Facility		$895.00	$3,604.10	$7,276.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $653.35 / $2,526.09 / $3,299.24	Professional		$653.35	$2,526.09	$3,299.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $461.31 / $1,319.10 / $2,004.74	Facility		$461.31	$1,319.10	$2,004.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $998.14 / $1,743.25 / $2,091.90	Professional		$998.14	$1,743.25	$2,091.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $798.55 / $1,743.25 / $7,595.27	Facility		$798.55	$1,743.25	$7,595.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $785.24 / $1,076.40 / $1,898.18	Professional		$785.24	$1,076.40	$1,898.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,016.97	Professional		$50.00	$70.00	$1,016.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $461.31 / $1,319.10 / $2,004.74	Facility		$461.31	$1,319.10	$2,004.74
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $998.14 / $1,743.25 / $2,091.90	Professional		$998.14	$1,743.25	$2,091.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,743.25 / $2,682.79 / $4,287.81	Professional		$1,743.25	$2,682.79	$4,287.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $895.00 / $3,404.78 / $7,595.27	Facility		$895.00	$3,404.78	$7,595.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $653.35 / $895.00 / $8,690.21	Professional		$653.35	$895.00	$8,690.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,743.25 / $1,743.25 / $1,743.25	Professional		$1,743.25	$1,743.25	$1,743.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,743.25 / $1,743.25 / $1,743.25	Professional		$1,743.25	$1,743.25	$1,743.25
United Facility/Professional Professional Modifier Low / Median / High Price $595.48 / $952.76 / $1,495.10	Professional		$595.48	$952.76	$1,495.10