Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $468.46 / $468.46 / $468.46	Facility		$468.46	$468.46	$468.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $409.13 / $477.30 / $645.24	Professional		$409.13	$477.30	$645.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $928.63 / $1,021.49 / $1,690.11	Facility		$928.63	$1,021.49	$1,690.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $835.76 / $863.63 / $1,142.21	Professional		$835.76	$863.63	$1,142.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $668.07 / $1,987.27 / $1,987.27	Facility		$668.07	$1,987.27	$1,987.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.14 / $1,920.27 / $3,876.79	Facility		$501.14	$1,920.27	$3,876.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.83 / $1,345.78 / $1,757.51	Professional		$365.83	$1,345.78	$1,757.51
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $258.31 / $702.69 / $1,067.92	Facility		$258.31	$702.69	$1,067.92
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $531.72 / $928.63 / $1,114.35	Professional		$531.72	$928.63	$1,114.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $447.14 / $928.63 / $4,303.54	Facility		$447.14	$928.63	$4,303.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $374.19 / $475.94 / $1,011.17	Professional		$374.19	$475.94	$1,011.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $605.14	Professional		$50.00	$70.00	$605.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $258.31 / $702.69 / $1,067.92	Facility		$258.31	$702.69	$1,067.92
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $531.72 / $928.63 / $1,114.35	Professional		$531.72	$928.63	$1,114.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $928.63 / $1,429.14 / $2,400.85	Professional		$928.63	$1,429.14	$2,400.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $501.14 / $1,813.74 / $4,303.54	Facility		$501.14	$1,813.74	$4,303.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $365.83 / $501.14 / $5,650.92	Professional		$365.83	$501.14	$5,650.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $928.63 / $928.63 / $928.63	Professional		$928.63	$928.63	$928.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $741.50 / $928.63 / $928.63	Professional		$741.50	$928.63	$928.63
United Facility/Professional Professional Modifier Low / Median / High Price $333.43 / $466.80 / $928.63	Professional		$333.43	$466.80	$928.63