Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $410.38 / $410.38 / $410.38	Facility		$410.38	$410.38	$410.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $410.38 / $527.47 / $1,003.42	Professional		$410.38	$527.47	$1,003.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $659.19 / $725.11 / $1,199.73	Facility		$659.19	$725.11	$1,199.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $613.04 / $659.19 / $823.98	Professional		$613.04	$659.19	$823.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $889.80 / $1,410.67 / $1,410.67	Facility		$889.80	$1,410.67	$1,410.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.68 / $2,448.39 / $3,158.82	Facility		$758.68	$2,448.39	$3,158.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $553.84 / $1,091.46 / $1,240.30	Professional		$553.84	$1,091.46	$1,240.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $249.06 / $615.57 / $791.03	Facility		$249.06	$615.57	$791.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $342.04 / $659.19 / $791.03	Professional		$342.04	$659.19	$791.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $410.38 / $761.30 / $3,377.04	Facility		$410.38	$761.30	$3,377.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $551.38 / $648.77 / $1,182.69	Professional		$551.38	$648.77	$1,182.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $130.78	Professional		$50.00	$70.00	$130.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $249.06 / $619.52 / $791.03	Facility		$249.06	$619.52	$791.03
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $342.04 / $659.19 / $791.03	Professional		$342.04	$659.19	$791.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $659.19 / $799.84 / $1,510.04	Professional		$659.19	$799.84	$1,510.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $758.68 / $1,279.98 / $3,377.04	Facility		$758.68	$1,279.98	$3,377.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $553.84 / $758.68 / $5,142.14	Professional		$553.84	$758.68	$5,142.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,006.69 / $1,006.69 / $1,006.69	Professional		$1,006.69	$1,006.69	$1,006.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,006.69 / $1,006.69 / $1,006.69	Professional		$1,006.69	$1,006.69	$1,006.69
United Facility/Professional Professional Modifier Low / Median / High Price $492.75 / $617.05 / $1,060.80	Professional		$492.75	$617.05	$1,060.80