Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.50 / $486.87 / $723.81	Facility		$389.50	$486.87	$723.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $249.93 / $308.35 / $500.86	Professional		$249.93	$308.35	$500.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $697.85 / $843.91 / $892.60	Facility		$697.85	$843.91	$892.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.83 / $324.58 / $1,390.25	Professional		$129.83	$324.58	$1,390.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $324.58 / $482.08 / $824.43	Facility		$324.58	$482.08	$824.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $324.58 / $340.81 / $419.49	Professional		$324.58	$340.81	$419.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $893.01 / $1,043.55 / $1,600.84	Facility		$893.01	$1,043.55	$1,600.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $372.94 / $874.03 / $993.21	Professional		$372.94	$874.03	$993.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $249.93 / $389.50 / $1,136.03	Facility		$249.93	$389.50	$1,136.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $292.12 / $389.50 / $1,136.03	Facility		$292.12	$389.50	$1,136.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $164.76 / $199.09 / $1,000.96	Professional		$164.76	$199.09	$1,000.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $264.01	Professional		$50.00	$70.00	$264.01
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $249.93 / $389.50 / $1,136.03	Facility		$249.93	$389.50	$1,136.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $630.41 / $791.17 / $1,085.05	Professional		$630.41	$791.17	$1,085.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $649.16 / $1,541.76 / $1,541.76	Facility		$649.16	$1,541.76	$1,541.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $470.64 / $1,622.90 / $1,622.90	Professional		$470.64	$1,622.90	$1,622.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $248.87 / $248.87 / $691.21	Professional		$248.87	$248.87	$691.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $248.87 / $248.87 / $1,772.21	Professional		$248.87	$248.87	$1,772.21
United Facility/Professional Facility Modifier Low / Median / High Price $324.58 / $324.58 / $324.58	Facility		$324.58	$324.58	$324.58
United Facility/Professional Professional Modifier Low / Median / High Price $141.09 / $199.09 / $889.51	Professional		$141.09	$199.09	$889.51