Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $978.65 / $978.65 / $978.65	Facility		$978.65	$978.65	$978.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $808.15 / $978.65 / $1,630.77	Professional		$808.15	$978.65	$1,630.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,939.99 / $2,133.98 / $3,530.78	Facility		$1,939.99	$2,133.98	$3,530.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,745.99 / $1,804.19 / $2,386.17	Professional		$1,745.99	$1,804.19	$2,386.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,395.62 / $4,151.58 / $4,151.58	Facility		$1,395.62	$4,151.58	$4,151.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,254.96 / $4,010.29 / $8,097.88	Facility		$1,254.96	$4,010.29	$8,097.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $916.12 / $2,811.09 / $3,671.58	Professional		$916.12	$2,811.09	$3,671.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $624.82 / $1,467.98 / $2,230.98	Facility		$624.82	$1,467.98	$2,230.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,110.79 / $1,939.99 / $2,327.98	Professional		$1,110.79	$1,939.99	$2,327.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $978.65 / $1,932.46 / $9,310.49	Facility		$978.65	$1,932.46	$9,310.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $902.00 / $1,296.25 / $2,133.98	Professional		$902.00	$1,296.25	$2,133.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $990.41	Professional		$50.00	$70.00	$990.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $624.82 / $1,467.98 / $2,230.98	Facility		$624.82	$1,467.98	$2,230.98
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,110.79 / $1,939.99 / $2,327.98	Professional		$1,110.79	$1,939.99	$2,327.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,939.99 / $2,985.58 / $5,807.41	Professional		$1,939.99	$2,985.58	$5,807.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,254.96 / $3,789.04 / $9,310.49	Facility		$1,254.96	$3,789.04	$9,310.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $916.12 / $1,254.96 / $12,803.92	Professional		$916.12	$1,254.96	$12,803.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,939.99 / $1,939.99 / $1,939.99	Professional		$1,939.99	$1,939.99	$1,939.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,939.99 / $1,939.99 / $1,939.99	Professional		$1,939.99	$1,939.99	$1,939.99
United Facility/Professional Facility Modifier Low / Median / High Price $969.63 / $969.63 / $969.63	Facility		$969.63	$969.63	$969.63
United Facility/Professional Professional Modifier Low / Median / High Price $757.81 / $1,151.24 / $1,663.84	Professional		$757.81	$1,151.24	$1,663.84