Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $399.91 / $399.91 / $399.91	Facility		$399.91	$399.91	$399.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.48 / $399.91 / $745.40	Professional		$392.48	$399.91	$745.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $792.74 / $872.01 / $1,442.79	Facility		$792.74	$872.01	$1,442.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $713.46 / $737.25 / $975.07	Professional		$713.46	$737.25	$975.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $570.29 / $1,696.46 / $1,696.46	Facility		$570.29	$1,696.46	$1,696.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.80 / $1,750.21 / $3,308.57	Facility		$512.80	$1,750.21	$3,308.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $374.35 / $1,148.91 / $1,500.33	Professional		$374.35	$1,148.91	$1,500.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $231.33 / $599.87 / $911.65	Facility		$231.33	$599.87	$911.65
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $453.90 / $792.74 / $957.68	Professional		$453.90	$792.74	$957.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $399.91 / $792.74 / $3,769.74	Facility		$399.91	$792.74	$3,769.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $355.13 / $418.05 / $894.99	Professional		$355.13	$418.05	$894.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $534.98	Professional		$50.00	$70.00	$534.98
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $231.33 / $599.87 / $911.65	Facility		$231.33	$599.87	$911.65
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $453.90 / $792.74 / $957.68	Professional		$453.90	$792.74	$957.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $792.74 / $1,219.99 / $2,149.92	Professional		$792.74	$1,219.99	$2,149.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $512.80 / $1,548.32 / $3,769.74	Facility		$512.80	$1,548.32	$3,769.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $374.35 / $512.80 / $5,413.46	Professional		$374.35	$512.80	$5,413.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $792.74 / $792.74 / $792.74	Professional		$792.74	$792.74	$792.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $792.74 / $792.74 / $792.74	Professional		$792.74	$792.74	$792.74
United Facility/Professional Professional Modifier Low / Median / High Price $280.57 / $395.49 / $702.85	Professional		$280.57	$395.49	$702.85