Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $753.87 / $753.87 / $753.87	Facility		$753.87	$753.87	$753.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $625.89 / $753.87 / $1,263.00	Professional		$625.89	$753.87	$1,263.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,494.39 / $1,643.83 / $2,719.79	Facility		$1,494.39	$1,643.83	$2,719.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,292.49 / $1,389.78 / $1,838.09	Professional		$1,292.49	$1,389.78	$1,838.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,075.06 / $3,197.99 / $3,197.99	Facility		$1,075.06	$3,197.99	$3,197.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $967.10 / $3,299.03 / $6,237.86	Facility		$967.10	$3,299.03	$6,237.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $705.98 / $2,200.28 / $2,828.26	Professional		$705.98	$2,200.28	$2,828.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $451.45 / $1,195.51 / $1,718.55	Facility		$451.45	$1,195.51	$1,718.55
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,458.52 / $1,494.39 / $1,793.27	Professional		$1,458.52	$1,494.39	$1,793.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $753.87 / $1,494.39 / $6,958.79	Facility		$753.87	$1,494.39	$6,958.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $685.93 / $1,002.23 / $1,635.76	Professional		$685.93	$1,002.23	$1,635.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $997.54	Professional		$50.00	$70.00	$997.54
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $451.45 / $1,195.51 / $1,718.55	Facility		$451.45	$1,195.51	$1,718.55
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,458.52 / $1,494.39 / $1,793.27	Professional		$1,458.52	$1,494.39	$1,793.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,494.39 / $2,299.81 / $3,995.73	Professional		$1,494.39	$2,299.81	$3,995.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $967.10 / $2,918.74 / $6,958.79	Facility		$967.10	$2,918.74	$6,958.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $705.98 / $967.10 / $7,523.58	Professional		$705.98	$967.10	$7,523.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,494.39 / $1,494.39 / $1,494.39	Professional		$1,494.39	$1,494.39	$1,494.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,494.39 / $1,494.39 / $1,494.39	Professional		$1,494.39	$1,494.39	$1,494.39
United Facility/Professional Professional Modifier Low / Median / High Price $595.35 / $896.63 / $1,281.68	Professional		$595.35	$896.63	$1,281.68