Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $509.27 / $964.14 / $1,135.67	Facility		$509.27	$964.14	$1,135.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $510.41 / $849.43	Professional		$495.55	$510.41	$849.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $619.44 / $916.77 / $1,105.08	Facility		$619.44	$916.77	$1,105.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $629.34	Professional		$495.55	$495.55	$629.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $678.46 / $678.46 / $792.88	Facility		$678.46	$678.46	$792.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $495.55 / $631.13 / $1,347.69	Facility		$495.55	$631.13	$1,347.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $738.47 / $839.18	Professional		$495.55	$738.47	$839.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $494.43 / $494.43 / $1,092.07	Facility		$494.43	$494.43	$1,092.07
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $741.65 / $991.10 / $991.10	Professional		$741.65	$991.10	$991.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $494.43 / $494.43 / $1,089.92	Facility		$494.43	$494.43	$1,089.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $494.43 / $494.43 / $991.10	Professional		$494.43	$494.43	$991.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $484.40 / $1,181.94	Professional		$85.00	$484.40	$1,181.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $494.43 / $494.43 / $1,092.07	Facility		$494.43	$494.43	$1,092.07
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $741.65 / $991.10 / $991.10	Professional		$741.65	$991.10	$991.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $750.82 / $1,618.74	Professional		$495.55	$750.82	$1,618.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $495.55 / $495.55 / $2,422.00	Facility		$495.55	$495.55	$2,422.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $495.55	Professional		$495.55	$495.55	$495.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $695.75 / $695.75 / $695.75	Professional		$695.75	$695.75	$695.75
United Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $644.22	Professional		$495.55	$495.55	$644.22