Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.12 / $389.12 / $389.12	Facility		$389.12	$389.12	$389.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.12 / $604.08 / $877.35	Professional		$389.12	$604.08	$877.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $654.99 / $720.49 / $1,192.08	Facility		$654.99	$720.49	$1,192.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $609.14 / $654.99 / $805.63	Professional		$609.14	$654.99	$805.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $777.73 / $1,401.68 / $1,401.68	Facility		$777.73	$1,401.68	$1,401.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $636.97 / $2,154.77 / $2,677.37	Facility		$636.97	$2,154.77	$2,677.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $464.99 / $950.12 / $1,232.39	Professional		$464.99	$950.12	$1,232.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $389.12 / $583.67 / $785.99	Facility		$389.12	$583.67	$785.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $584.98 / $654.99 / $785.99	Professional		$584.98	$654.99	$785.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $425.96 / $700.42 / $3,153.85	Facility		$425.96	$700.42	$3,153.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $500.17 / $577.12 / $984.92	Professional		$500.17	$577.12	$984.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $611.30	Professional		$50.00	$70.00	$611.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $389.12 / $583.67 / $785.99	Facility		$389.12	$583.67	$785.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $584.98 / $654.99 / $785.99	Professional		$584.98	$654.99	$785.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $654.99 / $1,335.18 / $1,740.42	Professional		$654.99	$1,335.18	$1,740.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $636.97 / $1,271.82 / $3,153.85	Facility		$636.97	$1,271.82	$3,153.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $464.99 / $636.97 / $4,494.50	Professional		$464.99	$636.97	$4,494.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $898.03 / $898.03 / $898.03	Professional		$898.03	$898.03	$898.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $898.03 / $898.03 / $898.03	Professional		$898.03	$898.03	$898.03
United Facility/Professional Professional Modifier Low / Median / High Price $384.75 / $562.11 / $902.54	Professional		$384.75	$562.11	$902.54