Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $384.08 / $384.08 / $384.08	Facility		$384.08	$384.08	$384.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $310.54 / $384.08 / $584.04	Professional		$310.54	$384.08	$584.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $761.36 / $837.50 / $1,385.68	Facility		$761.36	$837.50	$1,385.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $708.06 / $708.06 / $936.47	Professional		$708.06	$708.06	$936.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $547.72 / $1,629.31 / $1,629.31	Facility		$547.72	$1,629.31	$1,629.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $408.60 / $1,574.11 / $3,178.41	Facility		$408.60	$1,574.11	$3,178.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.27 / $1,103.44 / $1,440.94	Professional		$298.27	$1,103.44	$1,440.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $210.61 / $572.28 / $875.56	Facility		$210.61	$572.28	$875.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $435.93 / $761.36 / $913.63	Professional		$435.93	$761.36	$913.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $364.57 / $761.36 / $3,518.89	Facility		$364.57	$761.36	$3,518.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $303.32 / $388.05 / $829.03	Professional		$303.32	$388.05	$829.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $529.49	Professional		$50.00	$70.00	$529.49
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $210.61 / $576.12 / $875.56	Facility		$210.61	$576.12	$875.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $435.93 / $761.36 / $913.63	Professional		$435.93	$761.36	$913.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $761.36 / $1,170.00 / $1,957.22	Professional		$761.36	$1,170.00	$1,957.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $408.60 / $1,487.04 / $3,518.89	Facility		$408.60	$1,487.04	$3,518.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $298.27 / $408.60 / $4,535.78	Professional		$298.27	$408.60	$4,535.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $761.36 / $761.36 / $761.36	Professional		$761.36	$761.36	$761.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $607.91 / $761.36 / $761.36	Professional		$607.91	$761.36	$761.36
United Facility/Professional Professional Modifier Low / Median / High Price $271.86 / $379.84 / $728.02	Professional		$271.86	$379.84	$728.02