Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,408.74 / $1,408.74 / $1,408.74	Facility		$1,408.74	$1,408.74	$1,408.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,408.74 / $1,461.57 / $1,760.93	Professional		$1,408.74	$1,461.57	$1,760.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $864.65 / $951.12 / $1,573.66	Facility		$864.65	$951.12	$1,573.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $804.12 / $1,080.81 / $1,467.44	Professional		$804.12	$1,080.81	$1,467.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $622.02 / $1,850.35 / $1,850.35	Facility		$622.02	$1,850.35	$1,850.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $482.77 / $2,579.00 / $3,609.48	Facility		$482.77	$2,579.00	$3,609.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $410.35 / $1,440.04 / $1,636.41	Professional		$410.35	$1,440.04	$1,636.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $691.72 / $1,408.74 / $2,113.11	Facility		$691.72	$1,408.74	$2,113.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $843.92 / $864.65 / $1,037.58	Professional		$843.92	$864.65	$1,037.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $864.65 / $1,496.79 / $4,027.33	Facility		$864.65	$1,496.79	$4,027.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $402.02 / $580.74 / $963.60	Professional		$402.02	$580.74	$963.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $551.14	Professional		$50.00	$70.00	$551.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $712.52 / $1,408.74 / $2,113.11	Facility		$712.52	$1,408.74	$2,113.11
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $843.92 / $864.65 / $1,037.58	Professional		$843.92	$864.65	$1,037.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $864.65 / $1,330.65 / $2,312.52	Professional		$864.65	$1,330.65	$2,312.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $482.77 / $1,688.76 / $4,027.33	Facility		$482.77	$1,688.76	$4,027.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $410.35 / $482.77 / $4,361.83	Professional		$410.35	$482.77	$4,361.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $864.65 / $864.65 / $864.65	Professional		$864.65	$864.65	$864.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $864.65 / $864.65 / $864.65	Professional		$864.65	$864.65	$864.65
United Facility/Professional Professional Modifier Low / Median / High Price $344.46 / $551.14 / $864.65	Professional		$344.46	$551.14	$864.65