Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.41 / $323.41 / $323.41	Facility		$323.41	$323.41	$323.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.89 / $323.41 / $571.42	Professional		$300.89	$323.41	$571.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $641.10 / $705.21 / $1,166.80	Facility		$641.10	$705.21	$1,166.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $576.99 / $596.22 / $788.55	Professional		$576.99	$596.22	$788.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $461.19 / $1,371.95 / $1,371.95	Facility		$461.19	$1,371.95	$1,371.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $419.04 / $1,325.49 / $2,675.97	Facility		$419.04	$1,325.49	$2,675.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.89 / $929.06 / $1,213.33	Professional		$305.89	$929.06	$1,213.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $179.74 / $485.12 / $737.27	Facility		$179.74	$485.12	$737.27
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $367.07 / $641.10 / $769.32	Professional		$367.07	$641.10	$769.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $311.14 / $641.10 / $2,961.69	Facility		$311.14	$641.10	$2,961.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $272.69 / $331.17 / $698.07	Professional		$272.69	$331.17	$698.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $252.14	Professional		$50.00	$70.00	$252.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $179.74 / $485.12 / $737.27	Facility		$179.74	$485.12	$737.27
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $367.07 / $641.10 / $769.32	Professional		$367.07	$641.10	$769.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $641.10 / $986.62 / $1,670.16	Professional		$641.10	$986.62	$1,670.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $419.04 / $1,252.14 / $2,961.69	Facility		$419.04	$1,252.14	$2,961.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $305.89 / $419.04 / $3,571.63	Professional		$305.89	$419.04	$3,571.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $641.10 / $641.10 / $641.10	Professional		$641.10	$641.10	$641.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $511.90 / $641.10 / $641.10	Professional		$511.90	$641.10	$641.10
United Facility/Professional Professional Modifier Low / Median / High Price $232.01 / $319.83 / $696.03	Professional		$232.01	$319.83	$696.03