Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $805.85 / $805.85 / $805.85	Facility		$805.85	$805.85	$805.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $669.08 / $805.85 / $1,350.14	Professional		$669.08	$805.85	$1,350.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,597.45 / $1,757.20 / $2,907.36	Facility		$1,597.45	$1,757.20	$2,907.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,437.70 / $1,485.63 / $1,964.86	Professional		$1,437.70	$1,485.63	$1,964.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,149.20 / $3,418.54 / $3,418.54	Facility		$1,149.20	$3,418.54	$3,418.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.71 / $3,527.47 / $6,667.52	Facility		$891.71	$3,527.47	$6,667.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $650.95 / $2,351.71 / $3,023.30	Professional		$650.95	$2,351.71	$3,023.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $482.60 / $1,277.96 / $1,837.07	Facility		$482.60	$1,277.96	$1,837.07
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,559.19 / $1,597.45 / $1,916.94	Professional		$1,559.19	$1,597.45	$1,916.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $805.85 / $1,597.45 / $7,438.91	Facility		$805.85	$1,597.45	$7,438.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $733.24 / $1,071.36 / $1,748.58	Professional		$733.24	$1,071.36	$1,748.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $935.87	Professional		$50.00	$70.00	$935.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $482.60 / $1,277.96 / $1,837.07	Facility		$482.60	$1,277.96	$1,837.07
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,559.19 / $1,597.45 / $1,916.94	Professional		$1,559.19	$1,597.45	$1,916.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,597.45 / $2,458.41 / $4,271.75	Professional		$1,597.45	$2,458.41	$4,271.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $891.71 / $3,120.02 / $7,438.91	Facility		$891.71	$3,120.02	$7,438.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $650.95 / $891.71 / $8,042.55	Professional		$650.95	$891.71	$8,042.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,597.45 / $1,597.45 / $1,597.45	Professional		$1,597.45	$1,597.45	$1,597.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,597.45 / $1,597.45 / $1,597.45	Professional		$1,597.45	$1,597.45	$1,597.45
United Facility/Professional Professional Modifier Low / Median / High Price $593.29 / $949.26 / $1,597.45	Professional		$593.29	$949.26	$1,597.45