Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $466.79 / $466.79 / $466.79	Facility		$466.79	$466.79	$466.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $441.80 / $466.79 / $839.06	Professional		$441.80	$466.79	$839.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $925.33 / $1,017.86 / $1,684.10	Facility		$925.33	$1,017.86	$1,684.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $800.32 / $860.56 / $1,138.15	Professional		$800.32	$860.56	$1,138.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $665.68 / $1,980.21 / $1,980.21	Facility		$665.68	$1,980.21	$1,980.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $576.88 / $2,042.73 / $3,862.80	Facility		$576.88	$2,042.73	$3,862.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.12 / $1,362.55 / $1,751.25	Professional		$421.12	$1,362.55	$1,751.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $266.24 / $700.19 / $1,064.13	Facility		$266.24	$700.19	$1,064.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $529.83 / $903.14 / $1,110.40	Professional		$529.83	$903.14	$1,110.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $460.86 / $925.33 / $4,308.97	Facility		$460.86	$925.33	$4,308.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $404.05 / $484.72 / $1,007.57	Professional		$404.05	$484.72	$1,007.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $472.20	Professional		$50.00	$70.00	$472.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $266.24 / $700.19 / $1,064.13	Facility		$266.24	$700.19	$1,064.13
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $529.83 / $903.14 / $1,110.40	Professional		$529.83	$903.14	$1,110.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $925.33 / $1,424.06 / $2,474.12	Professional		$925.33	$1,424.06	$2,474.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $576.88 / $1,807.28 / $4,308.97	Facility		$576.88	$1,807.28	$4,308.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $421.12 / $576.88 / $4,658.79	Professional		$421.12	$576.88	$4,658.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $925.33 / $925.33 / $925.33	Professional		$925.33	$925.33	$925.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $925.33 / $925.33 / $925.33	Professional		$925.33	$925.33	$925.33
United Facility/Professional Facility Modifier Low / Median / High Price $1,322.59 / $1,322.59 / $1,322.59	Facility		$1,322.59	$1,322.59	$1,322.59
United Facility/Professional Professional Modifier Low / Median / High Price $322.89 / $461.63 / $820.41	Professional		$322.89	$461.63	$820.41