Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $326.70 / $326.70 / $326.70	Facility		$326.70	$326.70	$326.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.47 / $326.70 / $468.08	Professional		$246.47	$326.70	$468.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $647.63 / $712.39 / $1,178.69	Facility		$647.63	$712.39	$1,178.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $582.86 / $602.29 / $796.58	Professional		$582.86	$602.29	$796.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $465.89 / $1,385.93 / $1,385.93	Facility		$465.89	$1,385.93	$1,385.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $324.30 / $1,338.66 / $2,702.56	Facility		$324.30	$1,338.66	$2,702.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.74 / $1,078.60 / $1,225.69	Professional		$236.74	$1,078.60	$1,225.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $167.15 / $490.05 / $744.77	Facility		$167.15	$490.05	$744.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $370.81 / $647.63 / $777.16	Professional		$370.81	$647.63	$777.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $289.35 / $647.63 / $2,792.04	Facility		$289.35	$647.63	$2,792.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $256.61 / $323.08 / $705.18	Professional		$256.61	$323.08	$705.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $474.51	Professional		$50.00	$70.00	$474.51
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $167.15 / $490.05 / $744.77	Facility		$167.15	$490.05	$744.77
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $370.81 / $647.63 / $777.16	Professional		$370.81	$647.63	$777.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $647.63 / $990.40 / $1,553.73	Professional		$647.63	$990.40	$1,553.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $324.30 / $1,264.90 / $2,792.04	Facility		$324.30	$1,264.90	$2,792.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $236.74 / $324.30 / $3,321.60	Professional		$236.74	$324.30	$3,321.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $647.63 / $647.63 / $647.63	Professional		$647.63	$647.63	$647.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $647.63 / $647.63 / $647.63	Professional		$647.63	$647.63	$647.63
United Facility/Professional Professional Modifier Low / Median / High Price $215.77 / $323.08 / $574.20	Professional		$215.77	$323.08	$574.20