Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $947.98 / $947.98 / $947.98	Facility		$947.98	$947.98	$947.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $861.72 / $947.98 / $1,134.02	Professional		$861.72	$947.98	$1,134.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,131.79 / $1,244.97 / $2,059.86	Facility		$1,131.79	$1,244.97	$2,059.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,052.56 / $1,052.56 / $1,697.68	Professional		$1,052.56	$1,052.56	$1,697.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $814.20 / $2,422.03 / $2,422.03	Facility		$814.20	$2,422.03	$2,422.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,041.28 / $3,553.98 / $5,451.89	Facility		$3,041.28	$3,553.98	$5,451.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $517.14 / $1,884.96 / $2,142.00	Professional		$517.14	$1,884.96	$2,142.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $357.41 / $1,131.79 / $1,450.41	Facility		$357.41	$1,131.79	$1,450.41
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $648.04 / $648.04 / $1,358.15	Professional		$648.04	$648.04	$1,358.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $600.66 / $1,301.56 / $5,682.97	Facility		$600.66	$1,301.56	$5,682.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $509.82 / $627.07 / $1,358.15	Professional		$509.82	$627.07	$1,358.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $895.51	Professional		$50.00	$70.00	$895.51
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $357.41 / $1,131.79 / $1,699.57	Facility		$357.41	$1,131.79	$1,699.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $648.04 / $648.04 / $1,358.15	Professional		$648.04	$648.04	$1,358.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,131.79 / $1,718.96 / $3,224.89	Professional		$1,131.79	$1,718.96	$3,224.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,210.52 / $2,210.52 / $5,682.97	Facility		$2,210.52	$2,210.52	$5,682.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $517.14 / $4,973.67 / $7,994.61	Professional		$517.14	$4,973.67	$7,994.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,131.79 / $1,131.79 / $1,131.79	Professional		$1,131.79	$1,131.79	$1,131.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $860.68 / $992.31 / $1,012.56	Professional		$860.68	$992.31	$1,012.56
United Facility/Professional Professional Modifier Low / Median / High Price $420.85 / $578.95 / $1,277.78	Professional		$420.85	$578.95	$1,277.78