Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $420.68 / $420.68 / $420.68	Facility		$420.68	$420.68	$420.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $420.68 / $481.47 / $601.92	Professional		$420.68	$481.47	$601.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $833.93 / $917.32 / $1,517.75	Facility		$833.93	$917.32	$1,517.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $721.26 / $775.55 / $1,025.73	Professional		$721.26	$775.55	$1,025.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $599.91 / $1,784.61 / $1,784.61	Facility		$599.91	$1,784.61	$1,784.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $544.74 / $1,724.20 / $3,480.72	Facility		$544.74	$1,724.20	$3,480.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $397.66 / $1,208.44 / $1,578.26	Professional		$397.66	$1,208.44	$1,578.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $258.19 / $631.02 / $959.02	Facility		$258.19	$631.02	$959.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $477.49 / $833.93 / $1,000.72	Professional		$477.49	$833.93	$1,000.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $420.68 / $875.63 / $4,222.76	Facility		$420.68	$875.63	$4,222.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $375.64 / $478.03 / $908.04	Professional		$375.64	$478.03	$908.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $369.06	Professional		$50.00	$70.00	$369.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $258.19 / $631.02 / $959.02	Facility		$258.19	$631.02	$959.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $477.49 / $833.93 / $1,000.72	Professional		$477.49	$833.93	$1,000.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $833.93 / $1,283.38 / $2,399.85	Professional		$833.93	$1,283.38	$2,399.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $544.74 / $1,628.76 / $4,222.76	Facility		$544.74	$1,628.76	$4,222.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $397.66 / $544.74 / $5,103.60	Professional		$397.66	$544.74	$5,103.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $833.93 / $833.93 / $833.93	Professional		$833.93	$833.93	$833.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $665.87 / $833.93 / $833.93	Professional		$665.87	$833.93	$833.93
United Facility/Professional Professional Modifier Low / Median / High Price $313.14 / $462.21 / $797.40	Professional		$313.14	$462.21	$797.40