Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.77 / $263.77 / $263.77	Facility		$263.77	$263.77	$263.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.77 / $290.61 / $611.70	Professional		$263.77	$290.61	$611.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $522.86 / $575.15 / $951.61	Facility		$522.86	$575.15	$951.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $470.57 / $486.26 / $643.11	Professional		$470.57	$486.26	$643.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $376.15 / $1,118.92 / $1,118.92	Facility		$376.15	$1,118.92	$1,118.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $373.35 / $1,080.68 / $2,181.92	Facility		$373.35	$1,080.68	$2,181.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.55 / $757.50 / $989.56	Professional		$272.55	$757.50	$989.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $168.40 / $395.66 / $601.29	Facility		$168.40	$395.66	$601.29
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $299.38 / $522.86 / $697.15	Professional		$299.38	$522.86	$697.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $263.77 / $522.86 / $2,832.34	Facility		$263.77	$522.86	$2,832.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $236.85 / $304.33 / $590.29	Professional		$236.85	$304.33	$590.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $168.40 / $395.66 / $601.29	Facility		$168.40	$395.66	$601.29
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $299.38 / $522.86 / $697.15	Professional		$299.38	$522.86	$697.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $522.86 / $804.66 / $1,564.77	Professional		$522.86	$804.66	$1,564.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $373.35 / $1,021.22 / $2,832.34	Facility		$373.35	$1,021.22	$2,832.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $272.55 / $373.35 / $3,651.93	Professional		$272.55	$373.35	$3,651.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $522.86 / $522.86 / $522.86	Professional		$522.86	$522.86	$522.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $522.86 / $522.86 / $522.86	Professional		$522.86	$522.86	$522.86
United Facility/Professional Professional Modifier Low / Median / High Price $204.24 / $260.85 / $506.21	Professional		$204.24	$260.85	$506.21