Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $838.26 / $838.26 / $838.26	Facility		$838.26	$838.26	$838.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $678.60 / $838.26 / $1,391.83	Professional		$678.60	$838.26	$1,391.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,661.69 / $1,827.86 / $3,024.28	Facility		$1,661.69	$1,827.86	$3,024.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,495.52 / $1,545.37 / $2,043.87	Professional		$1,495.52	$1,545.37	$2,043.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $478.19 / $1,422.48 / $3,556.02	Facility		$478.19	$1,422.48	$3,556.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $926.75 / $3,435.25 / $6,936.24	Facility		$926.75	$3,435.25	$6,936.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $787.74 / $2,767.49 / $3,144.88	Professional		$787.74	$2,767.49	$3,144.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $477.68 / $1,257.39 / $1,910.94	Facility		$477.68	$1,257.39	$1,910.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $951.44 / $1,661.69 / $1,994.03	Professional		$951.44	$1,661.69	$1,994.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $826.88 / $1,661.69 / $7,755.74	Facility		$826.88	$1,661.69	$7,755.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $748.51 / $1,110.29 / $1,809.37	Professional		$748.51	$1,110.29	$1,809.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $1,059.19	Professional		$50.00	$85.00	$1,059.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $477.68 / $1,257.39 / $1,910.94	Facility		$477.68	$1,257.39	$1,910.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $951.44 / $1,661.69 / $1,994.03	Professional		$951.44	$1,661.69	$1,994.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,661.69 / $2,557.27 / $4,439.37	Professional		$1,661.69	$2,557.27	$4,439.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $926.75 / $3,245.48 / $7,755.74	Facility		$926.75	$3,245.48	$7,755.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $787.74 / $926.75 / $8,729.28	Professional		$787.74	$926.75	$8,729.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,661.69 / $1,661.69 / $1,661.69	Professional		$1,661.69	$1,661.69	$1,661.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,661.69 / $1,661.69 / $1,661.69	Professional		$1,661.69	$1,661.69	$1,661.69
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $986.56 / $1,473.28	Professional		$616.60	$986.56	$1,473.28