Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.27 / $389.27 / $389.27	Facility		$389.27	$389.27	$389.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.27 / $428.90 / $865.60	Professional		$389.27	$428.90	$865.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $771.65 / $848.82 / $1,404.40	Facility		$771.65	$848.82	$1,404.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $667.39 / $717.63 / $949.12	Professional		$667.39	$717.63	$949.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $555.13 / $1,651.33 / $1,651.33	Facility		$555.13	$1,651.33	$1,651.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $499.17 / $1,595.67 / $3,220.40	Facility		$499.17	$1,595.67	$3,220.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.39 / $1,118.44 / $1,460.41	Professional		$364.39	$1,118.44	$1,460.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $248.53 / $583.91 / $887.40	Facility		$248.53	$583.91	$887.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $441.83 / $771.65 / $954.09	Professional		$441.83	$771.65	$954.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $389.27 / $810.23 / $4,299.75	Facility		$389.27	$810.23	$4,299.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $349.55 / $449.13 / $871.19	Professional		$349.55	$449.13	$871.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $796.76	Professional		$50.00	$70.00	$796.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $248.53 / $583.91 / $887.40	Facility		$248.53	$583.91	$887.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $441.83 / $771.65 / $954.09	Professional		$441.83	$771.65	$954.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $771.65 / $1,187.55 / $2,309.51	Professional		$771.65	$1,187.55	$2,309.51
Quartz Facility/Professional Facility Modifier Low / Median / High Price $499.17 / $1,507.14 / $4,299.75	Facility		$499.17	$1,507.14	$4,299.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $364.39 / $499.17 / $5,092.91	Professional		$364.39	$499.17	$5,092.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $771.65 / $771.65 / $771.65	Professional		$771.65	$771.65	$771.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $771.65 / $771.65 / $771.65	Professional		$771.65	$771.65	$771.65
United Facility/Professional Professional Modifier Low / Median / High Price $307.42 / $427.39 / $840.23	Professional		$307.42	$427.39	$840.23