Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $498.42 / $498.42 / $498.42	Facility		$498.42	$498.42	$498.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $471.74 / $530.12 / $686.51	Professional		$471.74	$530.12	$686.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $988.03 / $1,086.83 / $1,798.21	Facility		$988.03	$1,086.83	$1,798.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $889.22 / $918.87 / $1,215.27	Professional		$889.22	$918.87	$1,215.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $710.79 / $2,114.38 / $2,114.38	Facility		$710.79	$2,114.38	$2,114.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $551.53 / $2,180.98 / $4,124.52	Facility		$551.53	$2,180.98	$4,124.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $402.62 / $1,454.47 / $1,869.91	Professional		$402.62	$1,454.47	$1,869.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $284.27 / $742.65 / $1,136.23	Facility		$284.27	$742.65	$1,136.23
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $565.71 / $964.39 / $1,185.64	Professional		$565.71	$964.39	$1,185.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $492.10 / $988.03 / $4,601.05	Facility		$492.10	$988.03	$4,601.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $431.44 / $523.79 / $1,075.83	Professional		$431.44	$523.79	$1,075.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $651.36	Professional		$50.00	$70.00	$651.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $284.27 / $747.63 / $1,136.23	Facility		$284.27	$747.63	$1,136.23
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $565.71 / $964.39 / $1,185.64	Professional		$565.71	$964.39	$1,185.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $988.03 / $1,520.54 / $2,641.74	Professional		$988.03	$1,520.54	$2,641.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $551.53 / $1,929.74 / $4,601.05	Facility		$551.53	$1,929.74	$4,601.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $402.62 / $551.53 / $4,974.32	Professional		$402.62	$551.53	$4,974.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $988.03 / $988.03 / $988.03	Professional		$988.03	$988.03	$988.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $788.91 / $988.03 / $988.03	Professional		$788.91	$988.03	$988.03
United Facility/Professional Professional Modifier Low / Median / High Price $366.96 / $492.92 / $944.76	Professional		$366.96	$492.92	$944.76