Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.81 / $253.81 / $253.81	Facility		$253.81	$253.81	$253.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.50 / $253.81 / $299.39	Professional		$159.50	$253.81	$299.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $378.50 / $688.87 / $688.87	Facility		$378.50	$688.87	$688.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $352.01 / $352.03 / $510.97	Professional		$352.01	$352.03	$510.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.73 / $215.36 / $810.05	Facility		$28.73	$215.36	$810.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.45 / $263.45 / $1,011.06	Facility		$263.45	$263.45	$1,011.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.93 / $438.75 / $548.44	Professional		$223.93	$438.75	$548.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $275.63 / $380.72 / $459.05	Facility		$275.63	$380.72	$459.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $479.00 / $479.00 / $479.00	Professional		$479.00	$479.00	$479.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $275.63 / $459.05 / $1,779.10	Facility		$275.63	$459.05	$1,779.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $166.45 / $226.97 / $479.00	Professional		$166.45	$226.97	$479.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $239.68	Professional		$50.00	$65.00	$239.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $275.63 / $380.72 / $459.05	Facility		$275.63	$380.72	$459.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $479.00 / $479.00 / $479.00	Professional		$479.00	$479.00	$479.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.96 / $92.29 / $119.83	Professional		$49.96	$92.29	$119.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $263.45 / $735.00 / $1,779.10	Facility		$263.45	$735.00	$1,779.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $263.45 / $263.45 / $325.44	Professional		$263.45	$263.45	$325.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $388.84 / $388.84 / $388.84	Professional		$388.84	$388.84	$388.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $388.84 / $388.84 / $388.84	Professional		$388.84	$388.84	$388.84
United Facility/Professional Professional Modifier Low / Median / High Price $157.15 / $220.75 / $388.84	Professional		$157.15	$220.75	$388.84