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 $623.70 / $644.49 / $852.39	Professional		$623.70	$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 $437.50 / $1,464.68 / $2,892.90	Facility		$437.50	$1,464.68	$2,892.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.38 / $1,004.06 / $1,311.56	Professional		$319.38	$1,004.06	$1,311.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $349.59 / $551.66 / $796.95	Facility		$349.59	$551.66	$796.95
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $676.39 / $693.00 / $831.60	Professional		$676.39	$693.00	$831.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $433.20 / $693.00 / $3,239.07	Facility		$433.20	$693.00	$3,239.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $314.94 / $367.37 / $772.13	Professional		$314.94	$367.37	$772.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $248.97	Professional		$50.00	$70.00	$248.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $349.59 / $554.40 / $796.95	Facility		$349.59	$554.40	$796.95
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $676.39 / $693.00 / $831.60	Professional		$676.39	$693.00	$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 $437.50 / $1,353.52 / $3,239.07	Facility		$437.50	$1,353.52	$3,239.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $319.38 / $437.50 / $3,488.94	Professional		$319.38	$437.50	$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 / $360.33 / $754.59	Professional		$241.83	$360.33	$754.59