Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $441.17 / $441.17 / $441.17	Facility		$441.17	$441.17	$441.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $441.17 / $486.08 / $969.02	Professional		$441.17	$486.08	$969.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $874.53 / $961.98 / $1,591.64	Facility		$874.53	$961.98	$1,591.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $756.37 / $813.31 / $1,075.67	Professional		$756.37	$813.31	$1,075.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $629.13 / $1,871.49 / $1,871.49	Facility		$629.13	$1,871.49	$1,871.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $565.73 / $1,807.67 / $3,650.06	Facility		$565.73	$1,807.67	$3,650.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $412.98 / $1,267.50 / $1,655.11	Professional		$412.98	$1,267.50	$1,655.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $281.66 / $661.76 / $1,005.71	Facility		$281.66	$661.76	$1,005.71
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $500.74 / $874.53 / $1,102.08	Professional		$500.74	$874.53	$1,102.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $441.17 / $874.53 / $4,661.22	Facility		$441.17	$874.53	$4,661.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $396.15 / $509.01 / $987.33	Professional		$396.15	$509.01	$987.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $449.81	Professional		$50.00	$70.00	$449.81
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $281.66 / $661.76 / $1,005.71	Facility		$281.66	$661.76	$1,005.71
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $500.74 / $874.53 / $1,102.08	Professional		$500.74	$874.53	$1,102.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $874.53 / $1,345.87 / $2,617.65	Professional		$874.53	$1,345.87	$2,617.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $565.73 / $1,708.06 / $4,661.22	Facility		$565.73	$1,708.06	$4,661.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $412.98 / $565.73 / $5,290.03	Professional		$412.98	$565.73	$5,290.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $874.53 / $874.53 / $874.53	Professional		$874.53	$874.53	$874.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $698.28 / $874.53 / $874.53	Professional		$698.28	$874.53	$874.53
United Facility/Professional Professional Modifier Low / Median / High Price $348.40 / $471.19 / $836.23	Professional		$348.40	$471.19	$836.23