Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $846.81 / $846.81 / $846.81	Facility		$846.81	$846.81	$846.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $605.75 / $846.81 / $1,406.03	Professional		$605.75	$846.81	$1,406.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,678.64 / $1,846.50 / $3,055.12	Facility		$1,678.64	$1,846.50	$3,055.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,451.86 / $1,561.14 / $2,064.71	Professional		$1,451.86	$1,561.14	$2,064.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,207.60 / $3,592.29 / $3,592.29	Facility		$1,207.60	$3,592.29	$3,592.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $908.63 / $3,705.79 / $7,006.22	Facility		$908.63	$3,705.79	$7,006.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.30 / $2,471.26 / $3,176.96	Professional		$663.30	$2,471.26	$3,176.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $468.34 / $1,270.22 / $1,930.44	Facility		$468.34	$1,270.22	$1,930.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $961.14 / $1,678.64 / $2,014.37	Professional		$961.14	$1,678.64	$2,014.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $810.71 / $1,678.64 / $7,783.07	Facility		$810.71	$1,678.64	$7,783.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $761.12 / $1,092.79 / $1,827.84	Professional		$761.12	$1,092.79	$1,827.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $931.87	Professional		$50.00	$70.00	$931.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $468.34 / $1,270.22 / $1,930.44	Facility		$468.34	$1,270.22	$1,930.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $961.14 / $1,678.64 / $2,014.37	Professional		$961.14	$1,678.64	$2,014.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,678.64 / $2,583.37 / $4,353.05	Professional		$1,678.64	$2,583.37	$4,353.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $908.63 / $3,278.60 / $7,783.07	Facility		$908.63	$3,278.60	$7,783.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $663.30 / $908.63 / $9,825.29	Professional		$663.30	$908.63	$9,825.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,678.64 / $1,678.64 / $1,678.64	Professional		$1,678.64	$1,678.64	$1,678.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,678.64 / $1,678.64 / $1,678.64	Professional		$1,678.64	$1,678.64	$1,678.64
United Facility/Professional Facility Modifier Low / Median / High Price $2,326.62 / $2,326.62 / $2,326.62	Facility		$2,326.62	$2,326.62	$2,326.62
United Facility/Professional Professional Modifier Low / Median / High Price $655.67 / $1,007.18 / $1,678.64	Professional		$655.67	$1,007.18	$1,678.64