Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $287.73 / $287.73 / $287.73	Facility		$287.73	$287.73	$287.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.87 / $287.73 / $468.85	Professional		$246.87	$287.73	$468.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $570.38 / $627.41 / $1,038.08	Facility		$570.38	$627.41	$1,038.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $513.34 / $530.45 / $701.56	Professional		$513.34	$530.45	$701.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $410.32 / $1,220.60 / $1,220.60	Facility		$410.32	$1,220.60	$1,220.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $379.04 / $1,179.17 / $2,380.66	Facility		$379.04	$1,179.17	$2,380.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.70 / $949.95 / $1,079.49	Professional		$276.70	$949.95	$1,079.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $167.43 / $431.60 / $655.94	Facility		$167.43	$431.60	$655.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $326.57 / $519.84 / $684.46	Professional		$326.57	$519.84	$684.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $287.73 / $570.38 / $2,777.77	Facility		$287.73	$570.38	$2,777.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $239.78 / $302.57 / $621.07	Professional		$239.78	$302.57	$621.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $303.95	Professional		$50.00	$70.00	$303.95
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $167.43 / $431.60 / $655.94	Facility		$167.43	$431.60	$655.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $326.57 / $519.84 / $684.46	Professional		$326.57	$519.84	$684.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $570.38 / $877.78 / $1,555.74	Professional		$570.38	$877.78	$1,555.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $379.04 / $1,114.02 / $2,777.77	Facility		$379.04	$1,114.02	$2,777.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $276.70 / $379.04 / $3,176.29	Professional		$276.70	$379.04	$3,176.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $570.38 / $570.38 / $570.38	Professional		$570.38	$570.38	$570.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $570.38 / $570.38 / $570.38	Professional		$570.38	$570.38	$570.38
United Facility/Professional Facility Modifier Low / Median / High Price $259.82 / $259.82 / $259.82	Facility		$259.82	$259.82	$259.82
United Facility/Professional Professional Modifier Low / Median / High Price $216.12 / $292.75 / $552.17	Professional		$216.12	$292.75	$552.17