Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.59 / $349.59 / $349.59	Facility		$349.59	$349.59	$349.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $330.90 / $349.59 / $628.42	Professional		$330.90	$349.59	$628.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $693.00 / $762.30 / $1,261.26	Facility		$693.00	$762.30	$1,261.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $599.37 / $644.49 / $852.39	Professional		$599.37	$644.49	$852.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $498.54 / $1,483.02 / $1,483.02	Facility		$498.54	$1,483.02	$1,483.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $386.84 / $1,432.44 / $2,892.90	Facility		$386.84	$1,432.44	$2,892.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $282.39 / $1,004.06 / $1,311.56	Professional		$282.39	$1,004.06	$1,311.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $199.39 / $524.39 / $796.95	Facility		$199.39	$524.39	$796.95
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $396.79 / $676.39 / $831.60	Professional		$396.79	$676.39	$831.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $345.14 / $693.00 / $3,239.07	Facility		$345.14	$693.00	$3,239.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $302.61 / $363.02 / $754.59	Professional		$302.61	$363.02	$754.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $451.26	Professional		$50.00	$65.00	$451.26
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $199.39 / $524.39 / $796.95	Facility		$199.39	$524.39	$796.95
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $396.79 / $676.39 / $831.60	Professional		$396.79	$676.39	$831.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $693.00 / $1,066.51 / $1,852.83	Professional		$693.00	$1,066.51	$1,852.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $386.84 / $1,353.52 / $3,239.07	Facility		$386.84	$1,353.52	$3,239.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $282.39 / $386.84 / $3,488.94	Professional		$282.39	$386.84	$3,488.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $693.00 / $693.00 / $693.00	Professional		$693.00	$693.00	$693.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $693.00 / $693.00 / $693.00	Professional		$693.00	$693.00	$693.00
United Facility/Professional Professional Modifier Low / Median / High Price $241.83 / $345.73 / $670.92	Professional		$241.83	$345.73	$670.92