Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $774.07 / $774.07 / $774.07	Facility		$774.07	$774.07	$774.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $625.50 / $774.07 / $1,285.25	Professional		$625.50	$774.07	$1,285.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,534.44 / $1,687.88 / $2,792.68	Facility		$1,534.44	$1,687.88	$2,792.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,373.35 / $1,427.03 / $1,887.36	Professional		$1,373.35	$1,427.03	$1,887.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,103.88 / $3,283.70 / $3,283.70	Facility		$1,103.88	$3,283.70	$3,283.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $843.35 / $3,388.20 / $6,404.40	Facility		$843.35	$3,388.20	$6,404.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $716.85 / $2,223.75 / $2,904.05	Professional		$716.85	$2,223.75	$2,904.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $456.43 / $1,227.55 / $1,764.61	Facility		$456.43	$1,227.55	$1,764.61
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,530.55 / $1,534.44 / $1,841.33	Professional		$1,530.55	$1,534.44	$1,841.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $774.07 / $1,534.44 / $7,017.00	Facility		$774.07	$1,534.44	$7,017.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $692.18 / $1,014.28 / $1,670.86	Professional		$692.18	$1,014.28	$1,670.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $456.43 / $1,227.55 / $1,764.61	Facility		$456.43	$1,227.55	$1,764.61
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,530.55 / $1,534.44 / $1,841.33	Professional		$1,530.55	$1,534.44	$1,841.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,534.44 / $2,361.46 / $4,039.89	Professional		$1,534.44	$2,361.46	$4,039.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $843.35 / $2,996.96 / $7,017.00	Facility		$843.35	$2,996.96	$7,017.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $716.85 / $843.35 / $7,615.67	Professional		$716.85	$843.35	$7,615.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,534.44 / $1,534.44 / $1,534.44	Professional		$1,534.44	$1,534.44	$1,534.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,534.44 / $1,534.44 / $1,534.44	Professional		$1,534.44	$1,534.44	$1,534.44
United Facility/Professional Facility Modifier Low / Median / High Price $2,159.44 / $2,159.44 / $2,159.44	Facility		$2,159.44	$2,159.44	$2,159.44
United Facility/Professional Professional Modifier Low / Median / High Price $527.21 / $920.66 / $1,534.44	Professional		$527.21	$920.66	$1,534.44