Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $303.95 / $303.95 / $303.95	Facility		$303.95	$303.95	$303.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.33 / $303.95 / $543.79	Professional		$286.33	$303.95	$543.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.54 / $662.79 / $1,096.61	Facility		$602.54	$662.79	$1,096.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $542.28 / $560.36 / $741.12	Professional		$542.28	$560.36	$741.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $433.48 / $1,289.44 / $1,289.44	Facility		$433.48	$1,289.44	$1,289.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $380.61 / $1,330.43 / $2,515.02	Facility		$380.61	$1,330.43	$2,515.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.85 / $1,003.52 / $1,140.35	Professional		$277.85	$1,003.52	$1,140.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $172.87 / $455.94 / $692.92	Facility		$172.87	$455.94	$692.92
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $345.00 / $602.54 / $723.05	Professional		$345.00	$602.54	$723.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $299.25 / $602.54 / $2,801.35	Facility		$299.25	$602.54	$2,801.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $261.11 / $315.64 / $656.10	Professional		$261.11	$315.64	$656.10
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 $172.87 / $455.94 / $692.92	Facility		$172.87	$455.94	$692.92
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $345.00 / $602.54 / $723.05	Professional		$345.00	$602.54	$723.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $602.54 / $927.32 / $1,606.92	Professional		$602.54	$927.32	$1,606.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $380.61 / $1,176.83 / $2,801.35	Facility		$380.61	$1,176.83	$2,801.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $277.85 / $380.61 / $2,991.55	Professional		$277.85	$380.61	$2,991.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $602.54 / $602.54 / $602.54	Professional		$602.54	$602.54	$602.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $602.54 / $602.54 / $602.54	Professional		$602.54	$602.54	$602.54
United Facility/Professional Professional Modifier Low / Median / High Price $223.15 / $309.48 / $602.54	Professional		$223.15	$309.48	$602.54