Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $488.69 / $488.69 / $488.69	Facility		$488.69	$488.69	$488.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $403.50 / $488.69 / $766.31	Professional		$403.50	$488.69	$766.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $968.74 / $1,065.60 / $1,763.11	Facility		$968.74	$1,065.60	$1,763.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $871.86 / $900.93 / $1,191.55	Professional		$871.86	$900.93	$1,191.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $696.91 / $2,073.10 / $2,073.10	Facility		$696.91	$2,073.10	$2,073.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $454.00 / $2,002.80 / $4,043.34	Facility		$454.00	$2,002.80	$4,043.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.42 / $1,403.91 / $1,833.40	Professional		$331.42	$1,403.91	$1,833.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $234.00 / $733.04 / $1,114.05	Facility		$234.00	$733.04	$1,114.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $554.66 / $960.53 / $1,162.49	Professional		$554.66	$960.53	$1,162.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $405.07 / $968.74 / $3,888.75	Facility		$405.07	$968.74	$3,888.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $359.24 / $483.29 / $1,054.83	Professional		$359.24	$483.29	$1,054.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $553.58	Professional		$50.00	$70.00	$553.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $234.00 / $733.04 / $1,114.05	Facility		$234.00	$733.04	$1,114.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $554.66 / $960.53 / $1,162.49	Professional		$554.66	$960.53	$1,162.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $968.74 / $1,453.11 / $2,175.02	Professional		$968.74	$1,453.11	$2,175.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $454.00 / $1,892.06 / $3,888.75	Facility		$454.00	$1,892.06	$3,888.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $331.42 / $454.00 / $4,610.54	Professional		$331.42	$454.00	$4,610.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $968.74 / $968.74 / $968.74	Professional		$968.74	$968.74	$968.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $968.74 / $968.74 / $968.74	Professional		$968.74	$968.74	$968.74
United Facility/Professional Professional Modifier Low / Median / High Price $322.20 / $483.29 / $926.31	Professional		$322.20	$483.29	$926.31