Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $490.21 / $490.21 / $490.21	Facility		$490.21	$490.21	$490.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $451.90 / $490.21 / $858.23	Professional		$451.90	$490.21	$858.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $971.75 / $1,068.93 / $1,768.59	Facility		$971.75	$1,068.93	$1,768.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $840.46 / $903.73 / $1,195.25	Professional		$840.46	$903.73	$1,195.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $699.06 / $2,079.55 / $2,079.55	Facility		$699.06	$2,079.55	$2,079.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $511.34 / $2,009.37 / $4,055.94	Facility		$511.34	$2,009.37	$4,055.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.28 / $1,408.13 / $1,839.10	Professional		$373.28	$1,408.13	$1,839.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $263.57 / $735.32 / $1,117.51	Facility		$263.57	$735.32	$1,117.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $556.39 / $971.75 / $1,166.09	Professional		$556.39	$971.75	$1,166.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $456.24 / $971.75 / $4,380.81	Facility		$456.24	$971.75	$4,380.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $404.62 / $485.62 / $1,058.10	Professional		$404.62	$485.62	$1,058.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $395.42	Professional		$50.00	$70.00	$395.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $263.57 / $735.32 / $1,117.51	Facility		$263.57	$735.32	$1,117.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $556.39 / $971.75 / $1,166.09	Professional		$556.39	$971.75	$1,166.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $971.75 / $1,495.47 / $2,450.03	Professional		$971.75	$1,495.47	$2,450.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $511.34 / $1,897.94 / $4,380.81	Facility		$511.34	$1,897.94	$4,380.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $373.28 / $511.34 / $5,237.28	Professional		$373.28	$511.34	$5,237.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $971.75 / $971.75 / $971.75	Professional		$971.75	$971.75	$971.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $971.75 / $971.75 / $971.75	Professional		$971.75	$971.75	$971.75
United Facility/Professional Facility Modifier Low / Median / High Price $0.65 / $430.05 / $462.96	Facility		$0.65	$430.05	$462.96
United Facility/Professional Professional Modifier Low / Median / High Price $340.22 / $484.79 / $971.75	Professional		$340.22	$484.79	$971.75