Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $397.54 / $397.54 / $397.54	Facility		$397.54	$397.54	$397.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $397.54 / $455.22 / $827.66	Professional		$397.54	$455.22	$827.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $638.50 / $702.35 / $1,162.07	Facility		$638.50	$702.35	$1,162.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $593.80 / $638.50 / $798.12	Professional		$593.80	$638.50	$798.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $862.08 / $1,366.39 / $1,366.39	Facility		$862.08	$1,366.39	$1,366.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.58 / $2,371.46 / $3,059.45	Facility		$736.58	$2,371.46	$3,059.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.70 / $1,057.20 / $1,201.35	Professional		$537.70	$1,057.20	$1,201.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $241.25 / $596.30 / $766.20	Facility		$241.25	$596.30	$766.20
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $331.31 / $638.50 / $766.20	Professional		$331.31	$638.50	$766.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $397.54 / $737.41 / $3,271.09	Facility		$397.54	$737.41	$3,271.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $534.05 / $635.27 / $1,145.84	Professional		$534.05	$635.27	$1,145.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $328.00	Professional		$50.00	$70.00	$328.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $241.25 / $600.13 / $766.20	Facility		$241.25	$600.13	$766.20
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $331.31 / $638.50 / $766.20	Professional		$331.31	$638.50	$766.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $638.50 / $774.60 / $1,462.86	Professional		$638.50	$774.60	$1,462.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $736.58 / $1,239.80 / $3,271.09	Facility		$736.58	$1,239.80	$3,271.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $537.70 / $761.97 / $4,981.95	Professional		$537.70	$761.97	$4,981.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $975.24 / $975.24 / $975.24	Professional		$975.24	$975.24	$975.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $975.24 / $975.24 / $975.24	Professional		$975.24	$975.24	$975.24
United Facility/Professional Professional Modifier Low / Median / High Price $418.93 / $597.83 / $996.39	Professional		$418.93	$597.83	$996.39