Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $514.95 / $514.95 / $514.95	Facility		$514.95	$514.95	$514.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.43 / $514.95 / $855.02	Professional		$348.43	$514.95	$855.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,020.79 / $1,122.86 / $1,857.84	Facility		$1,020.79	$1,122.86	$1,857.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $949.33 / $949.33 / $1,255.57	Professional		$949.33	$949.33	$1,255.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $734.37 / $2,184.48 / $2,184.48	Facility		$734.37	$2,184.48	$2,184.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $510.69 / $2,157.96 / $4,260.27	Facility		$510.69	$2,157.96	$4,260.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $434.09 / $1,503.05 / $1,931.94	Professional		$434.09	$1,503.05	$1,931.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $263.23 / $772.43 / $1,173.91	Facility		$263.23	$772.43	$1,173.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $584.50 / $945.34 / $1,224.95	Professional		$584.50	$945.34	$1,224.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $455.66 / $1,020.79 / $3,998.55	Facility		$455.66	$1,020.79	$3,998.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $459.83 / $614.20 / $1,111.52	Professional		$459.83	$614.20	$1,111.52
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 $263.23 / $772.43 / $1,173.91	Facility		$263.23	$772.43	$1,173.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $584.50 / $945.34 / $1,224.95	Professional		$584.50	$945.34	$1,224.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,020.79 / $1,559.89 / $2,446.02	Professional		$1,020.79	$1,559.89	$2,446.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $510.69 / $1,993.74 / $3,998.55	Facility		$510.69	$1,993.74	$3,998.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $434.09 / $510.69 / $4,776.42	Professional		$434.09	$510.69	$4,776.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,020.79 / $1,020.79 / $1,020.79	Professional		$1,020.79	$1,020.79	$1,020.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,020.79 / $1,020.79 / $1,020.79	Professional		$1,020.79	$1,020.79	$1,020.79
United Facility/Professional Professional Modifier Low / Median / High Price $368.52 / $613.59 / $1,019.34	Professional		$368.52	$613.59	$1,019.34