Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $254.00 / $254.00 / $254.00	Facility		$254.00	$254.00	$254.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.00 / $291.62 / $419.61	Professional		$254.00	$291.62	$419.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $503.51 / $553.86 / $916.39	Facility		$503.51	$553.86	$916.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $468.26 / $468.26 / $619.30	Professional		$468.26	$468.26	$619.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $362.22 / $1,077.51 / $1,077.51	Facility		$362.22	$1,077.51	$1,077.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $319.76 / $1,041.27 / $2,102.15	Facility		$319.76	$1,041.27	$2,102.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.42 / $838.59 / $952.94	Professional		$233.42	$838.59	$952.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $162.16 / $381.00 / $579.04	Facility		$162.16	$381.00	$579.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $288.30 / $503.51 / $671.35	Professional		$288.30	$503.51	$671.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $254.00 / $525.79 / $2,697.83	Facility		$254.00	$525.79	$2,697.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $228.09 / $293.06 / $568.46	Professional		$228.09	$293.06	$568.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $321.61	Professional		$50.00	$70.00	$321.61
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $162.16 / $381.00 / $579.04	Facility		$162.16	$381.00	$579.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $288.30 / $503.51 / $671.35	Professional		$288.30	$503.51	$671.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $503.51 / $774.88 / $1,507.56	Professional		$503.51	$774.88	$1,507.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $319.76 / $983.42 / $2,697.83	Facility		$319.76	$983.42	$2,697.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $233.42 / $319.76 / $3,222.48	Professional		$233.42	$319.76	$3,222.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $503.51 / $503.51 / $503.51	Professional		$503.51	$503.51	$503.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $402.04 / $503.51 / $503.51	Professional		$402.04	$503.51	$503.51
United Facility/Professional Professional Modifier Low / Median / High Price $196.68 / $254.57 / $481.46	Professional		$196.68	$254.57	$481.46