Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.44 / $467.44 / $467.44	Facility		$467.44	$467.44	$467.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.50 / $467.44 / $756.82	Professional		$398.50	$467.44	$756.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $926.61 / $1,019.27 / $1,686.43	Facility		$926.61	$1,019.27	$1,686.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $861.75 / $861.75 / $1,139.73	Professional		$861.75	$861.75	$1,139.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $666.61 / $1,982.95 / $1,982.95	Facility		$666.61	$1,982.95	$1,982.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.34 / $1,915.57 / $3,868.39	Facility		$524.34	$1,915.57	$3,868.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.77 / $1,342.97 / $1,753.68	Professional		$382.77	$1,342.97	$1,753.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $270.27 / $701.16 / $1,065.59	Facility		$270.27	$701.16	$1,065.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $530.54 / $926.61 / $1,118.84	Professional		$530.54	$926.61	$1,118.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $467.44 / $946.15 / $4,501.32	Facility		$467.44	$946.15	$4,501.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $387.06 / $488.41 / $1,046.11	Professional		$387.06	$488.41	$1,046.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $516.69	Professional		$50.00	$70.00	$516.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $270.27 / $701.16 / $1,065.59	Facility		$270.27	$701.16	$1,065.59
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $530.54 / $926.61 / $1,118.84	Professional		$530.54	$926.61	$1,118.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $926.61 / $1,426.01 / $2,512.26	Professional		$926.61	$1,426.01	$2,512.26
Quartz Facility/Professional Facility Modifier Low / Median / High Price $524.34 / $1,809.78 / $4,501.32	Facility		$524.34	$1,809.78	$4,501.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $382.77 / $524.34 / $5,538.31	Professional		$382.77	$524.34	$5,538.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $926.61 / $926.61 / $926.61	Professional		$926.61	$926.61	$926.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $926.61 / $926.61 / $926.61	Professional		$926.61	$926.61	$926.61
United Facility/Professional Professional Modifier Low / Median / High Price $369.15 / $483.83 / $926.61	Professional		$369.15	$483.83	$926.61