Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $862.49 / $862.49 / $862.49	Facility		$862.49	$862.49	$862.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $610.71 / $862.49 / $1,432.06	Professional		$610.71	$862.49	$1,432.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,709.72 / $1,880.69 / $3,111.69	Facility		$1,709.72	$1,880.69	$3,111.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,590.04 / $1,590.04 / $2,102.94	Professional		$1,590.04	$1,590.04	$2,102.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,229.96 / $3,658.80 / $3,658.80	Facility		$1,229.96	$3,658.80	$3,658.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,105.99 / $3,534.70 / $7,136.38	Facility		$1,105.99	$3,534.70	$7,136.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $807.37 / $2,477.81 / $3,235.79	Professional		$807.37	$2,477.81	$3,235.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $444.65 / $1,293.74 / $1,966.18	Facility		$444.65	$1,293.74	$1,966.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $978.94 / $1,552.55 / $2,051.66	Professional		$978.94	$1,552.55	$2,051.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $769.71 / $1,709.72 / $7,263.59	Facility		$769.71	$1,709.72	$7,263.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $766.57 / $1,037.53 / $1,861.68	Professional		$766.57	$1,037.53	$1,861.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,153.80	Professional		$50.00	$70.00	$1,153.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $444.65 / $1,293.74 / $1,966.18	Facility		$444.65	$1,293.74	$1,966.18
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $978.94 / $1,552.55 / $2,051.66	Professional		$978.94	$1,552.55	$2,051.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,709.72 / $2,631.19 / $4,133.24	Professional		$1,709.72	$2,631.19	$4,133.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,105.99 / $3,339.30 / $7,263.59	Facility		$1,105.99	$3,339.30	$7,263.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $807.37 / $1,105.99 / $8,124.39	Professional		$807.37	$1,105.99	$8,124.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,709.72 / $1,709.72 / $1,709.72	Professional		$1,709.72	$1,709.72	$1,709.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,709.72 / $1,709.72 / $1,709.72	Professional		$1,709.72	$1,709.72	$1,709.72
United Facility/Professional Professional Modifier Low / Median / High Price $573.98 / $918.36 / $1,709.72	Professional		$573.98	$918.36	$1,709.72