Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $596.66 / $596.66 / $596.66	Facility		$596.66	$596.66	$596.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $420.36 / $596.66 / $990.68	Professional		$420.36	$596.66	$990.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,182.76 / $1,301.04 / $2,152.62	Facility		$1,182.76	$1,301.04	$2,152.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,022.97 / $1,099.97 / $1,454.79	Professional		$1,022.97	$1,099.97	$1,454.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $850.87 / $2,531.11 / $2,531.11	Facility		$850.87	$2,531.11	$2,531.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.11 / $2,611.79 / $4,936.26	Facility		$765.11	$2,611.79	$4,936.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $558.53 / $1,741.17 / $2,238.46	Professional		$558.53	$1,741.17	$2,238.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $323.35 / $894.99 / $1,360.17	Facility		$323.35	$894.99	$1,360.17
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $677.22 / $1,182.76 / $1,419.31	Professional		$677.22	$1,182.76	$1,419.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $559.73 / $1,182.76 / $5,337.26	Facility		$559.73	$1,182.76	$5,337.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $535.24 / $754.48 / $1,287.88	Professional		$535.24	$754.48	$1,287.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $659.40	Professional		$50.00	$70.00	$659.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $323.35 / $894.99 / $1,360.17	Facility		$323.35	$894.99	$1,360.17
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $677.22 / $1,182.76 / $1,419.31	Professional		$677.22	$1,182.76	$1,419.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,182.76 / $1,820.23 / $3,005.08	Professional		$1,182.76	$1,820.23	$3,005.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $765.11 / $2,310.08 / $5,337.26	Facility		$765.11	$2,310.08	$5,337.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $558.53 / $765.11 / $6,425.38	Professional		$558.53	$765.11	$6,425.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,182.76 / $1,182.76 / $1,182.76	Professional		$1,182.76	$1,182.76	$1,182.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,182.76 / $1,182.76 / $1,182.76	Professional		$1,182.76	$1,182.76	$1,182.76
United Facility/Professional Professional Modifier Low / Median / High Price $471.20 / $667.82 / $1,048.65	Professional		$471.20	$667.82	$1,048.65