Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.99 / $288.99 / $288.99	Facility		$288.99	$288.99	$288.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.69 / $288.99 / $523.59	Professional		$275.69	$288.99	$523.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $572.88 / $630.16 / $1,042.64	Facility		$572.88	$630.16	$1,042.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $532.78 / $532.78 / $704.64	Professional		$532.78	$532.78	$704.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $412.13 / $1,225.96 / $1,225.96	Facility		$412.13	$1,225.96	$1,225.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $347.46 / $1,265.31 / $2,391.85	Facility		$347.46	$1,265.31	$2,391.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.65 / $830.16 / $1,084.21	Professional		$253.65	$830.16	$1,084.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $166.32 / $433.49 / $658.81	Facility		$166.32	$433.49	$658.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $328.02 / $572.88 / $687.46	Professional		$328.02	$572.88	$687.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $287.91 / $572.88 / $2,780.76	Facility		$287.91	$572.88	$2,780.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $252.12 / $300.57 / $644.07	Professional		$252.12	$300.57	$644.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $386.62	Professional		$50.00	$70.00	$386.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $166.32 / $433.49 / $658.81	Facility		$166.32	$433.49	$658.81
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $328.02 / $572.88 / $687.46	Professional		$328.02	$572.88	$687.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $572.88 / $881.66 / $1,545.70	Professional		$572.88	$881.66	$1,545.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $347.46 / $1,118.90 / $2,780.76	Facility		$347.46	$1,118.90	$2,780.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $253.65 / $347.46 / $3,264.96	Professional		$253.65	$347.46	$3,264.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $572.88 / $572.88 / $572.88	Professional		$572.88	$572.88	$572.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $572.88 / $572.88 / $572.88	Professional		$572.88	$572.88	$572.88
United Facility/Professional Professional Modifier Low / Median / High Price $228.23 / $300.57 / $572.88	Professional		$228.23	$300.57	$572.88