Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $491.20 / $491.20 / $491.20	Facility		$491.20	$491.20	$491.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $491.20 / $568.71 / $1,035.54	Professional		$491.20	$568.71	$1,035.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $762.72 / $838.99 / $1,388.15	Facility		$762.72	$838.99	$1,388.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $709.33 / $762.72 / $953.40	Professional		$709.33	$762.72	$953.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,122.92 / $1,632.22 / $1,632.22	Facility		$1,122.92	$1,632.22	$1,632.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $854.15 / $3,089.10 / $3,748.90	Facility		$854.15	$3,089.10	$3,748.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $623.53 / $1,262.90 / $1,435.11	Professional		$623.53	$1,262.90	$1,435.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $288.18 / $736.80 / $915.26	Facility		$288.18	$736.80	$915.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $395.76 / $762.72 / $915.26	Professional		$395.76	$762.72	$915.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $491.20 / $884.16 / $3,899.19	Facility		$491.20	$884.16	$3,899.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $630.26 / $778.72 / $1,492.55	Professional		$630.26	$778.72	$1,492.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $453.00	Professional		$50.00	$70.00	$453.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $288.18 / $739.37 / $915.26	Facility		$288.18	$739.37	$915.26
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $395.76 / $762.72 / $915.26	Professional		$395.76	$762.72	$915.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $762.72 / $925.26 / $1,844.54	Professional		$762.72	$925.26	$1,844.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $854.15 / $1,481.02 / $3,899.19	Facility		$854.15	$1,481.02	$3,899.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $623.53 / $854.15 / $6,489.35	Professional		$623.53	$854.15	$6,489.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,229.69 / $1,229.69 / $1,229.69	Professional		$1,229.69	$1,229.69	$1,229.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,229.69 / $1,229.69 / $1,229.69	Professional		$1,229.69	$1,229.69	$1,229.69
United Facility/Professional Professional Modifier Low / Median / High Price $525.22 / $778.72 / $1,297.86	Professional		$525.22	$778.72	$1,297.86