Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $951.43 / $951.43 / $951.43	Facility		$951.43	$951.43	$951.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $789.91 / $951.43 / $1,593.97	Professional		$789.91	$951.43	$1,593.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,886.02 / $2,074.62 / $3,432.56	Facility		$1,886.02	$2,074.62	$3,432.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,631.22 / $1,754.00 / $2,319.80	Professional		$1,631.22	$1,754.00	$2,319.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,356.80 / $4,036.08 / $4,036.08	Facility		$1,356.80	$4,036.08	$4,036.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,329.56 / $4,164.60 / $7,872.55	Facility		$1,329.56	$4,164.60	$7,872.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $970.58 / $3,141.12 / $3,569.45	Professional		$970.58	$3,141.12	$3,569.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $569.78 / $1,508.82 / $2,168.92	Facility		$569.78	$1,508.82	$2,168.92
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,840.86 / $1,886.02 / $2,263.21	Professional		$1,840.86	$1,886.02	$2,263.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $951.43 / $1,886.02 / $8,782.71	Facility		$951.43	$1,886.02	$8,782.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $865.68 / $1,264.91 / $2,064.41	Professional		$865.68	$1,264.91	$2,064.41
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 $569.78 / $1,508.82 / $2,168.92	Facility		$569.78	$1,508.82	$2,168.92
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,840.86 / $1,886.02 / $2,263.21	Professional		$1,840.86	$1,886.02	$2,263.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,886.02 / $2,902.53 / $5,043.59	Professional		$1,886.02	$2,902.53	$5,043.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,329.56 / $3,683.64 / $8,782.71	Facility		$1,329.56	$3,683.64	$8,782.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $970.58 / $1,329.56 / $9,495.57	Professional		$970.58	$1,329.56	$9,495.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,886.02 / $1,886.02 / $1,886.02	Professional		$1,886.02	$1,886.02	$1,886.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,886.02 / $1,886.02 / $1,886.02	Professional		$1,886.02	$1,886.02	$1,886.02
United Facility/Professional Professional Modifier Low / Median / High Price $751.37 / $1,120.74 / $1,672.18	Professional		$751.37	$1,120.74	$1,672.18