Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $368.43 / $368.43 / $368.43	Facility		$368.43	$368.43	$368.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $368.43 / $502.50 / $767.39	Professional		$368.43	$502.50	$767.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $624.85 / $687.34 / $1,137.23	Facility		$624.85	$687.34	$1,137.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $581.11 / $624.85 / $781.06	Professional		$581.11	$624.85	$781.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $726.08 / $1,337.18 / $1,337.18	Facility		$726.08	$1,337.18	$1,337.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $647.80 / $2,011.24 / $2,554.19	Facility		$647.80	$2,011.24	$2,554.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $472.90 / $1,034.60 / $1,175.69	Professional		$472.90	$1,034.60	$1,175.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $368.43 / $552.65 / $749.82	Facility		$368.43	$552.65	$749.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $558.05 / $624.85 / $749.82	Professional		$558.05	$624.85	$749.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $406.36 / $663.17 / $3,006.95	Facility		$406.36	$663.17	$3,006.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $459.39 / $558.05 / $884.66	Professional		$459.39	$558.05	$884.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $528.08	Professional		$50.00	$70.00	$528.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $368.43 / $552.65 / $749.82	Facility		$368.43	$552.65	$749.82
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $558.05 / $624.85 / $749.82	Professional		$558.05	$624.85	$749.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $624.85 / $1,268.52 / $1,661.12	Professional		$624.85	$1,268.52	$1,661.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $647.80 / $1,213.30 / $3,006.95	Facility		$647.80	$1,213.30	$3,006.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $472.90 / $647.80 / $4,196.00	Professional		$472.90	$647.80	$4,196.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $845.68 / $845.68 / $845.68	Professional		$845.68	$845.68	$845.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $845.68 / $845.68 / $845.68	Professional		$845.68	$845.68	$845.68
United Facility/Professional Professional Modifier Low / Median / High Price $382.83 / $507.41 / $853.21	Professional		$382.83	$507.41	$853.21