Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $370.48 / $370.48 / $370.48	Facility		$370.48	$370.48	$370.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $333.96 / $370.48 / $634.24	Professional		$333.96	$370.48	$634.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $734.39 / $807.83 / $1,336.59	Facility		$734.39	$807.83	$1,336.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $682.98 / $682.98 / $903.29	Professional		$682.98	$682.98	$903.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $528.33 / $1,571.59 / $1,571.59	Facility		$528.33	$1,571.59	$1,571.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.71 / $1,517.85 / $3,065.05	Facility		$408.71	$1,517.85	$3,065.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.36 / $1,064.06 / $1,389.90	Professional		$298.36	$1,064.06	$1,389.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $210.66 / $555.72 / $844.55	Facility		$210.66	$555.72	$844.55
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $420.49 / $734.39 / $881.27	Professional		$420.49	$734.39	$881.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $364.67 / $734.39 / $3,443.36	Facility		$364.67	$734.39	$3,443.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $305.42 / $384.70 / $815.81	Professional		$305.42	$384.70	$815.81
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 $210.66 / $555.72 / $844.55	Facility		$210.66	$555.72	$844.55
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $420.49 / $734.39 / $881.27	Professional		$420.49	$734.39	$881.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $734.39 / $1,130.22 / $1,958.22	Professional		$734.39	$1,130.22	$1,958.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $408.71 / $1,434.36 / $3,443.36	Facility		$408.71	$1,434.36	$3,443.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $298.36 / $408.71 / $5,061.74	Professional		$298.36	$408.71	$5,061.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $734.39 / $734.39 / $734.39	Professional		$734.39	$734.39	$734.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $734.39 / $734.39 / $734.39	Professional		$734.39	$734.39	$734.39
United Facility/Professional Professional Modifier Low / Median / High Price $271.94 / $366.38 / $799.67	Professional		$271.94	$366.38	$799.67