Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $377.96 / $377.96 / $377.96	Facility		$377.96	$377.96	$377.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $377.96 / $378.71 / $712.25	Professional		$377.96	$378.71	$712.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $749.24 / $824.16 / $1,363.62	Facility		$749.24	$824.16	$1,363.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $674.31 / $696.79 / $921.56	Professional		$674.31	$696.79	$921.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $538.99 / $1,603.37 / $1,603.37	Facility		$538.99	$1,603.37	$1,603.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $450.57 / $1,548.79 / $3,128.03	Facility		$450.57	$1,548.79	$3,128.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.92 / $1,085.63 / $1,418.00	Professional		$328.92	$1,085.63	$1,418.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $232.24 / $566.94 / $861.63	Facility		$232.24	$566.94	$861.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $428.98 / $749.24 / $961.43	Professional		$428.98	$749.24	$961.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $377.96 / $749.24 / $3,794.31	Facility		$377.96	$749.24	$3,794.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $337.48 / $419.69 / $845.83	Professional		$337.48	$419.69	$845.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $289.97	Professional		$50.00	$70.00	$289.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $232.24 / $566.94 / $861.63	Facility		$232.24	$566.94	$861.63
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $428.98 / $749.24 / $961.43	Professional		$428.98	$749.24	$961.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $749.24 / $1,153.04 / $2,158.96	Professional		$749.24	$1,153.04	$2,158.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $450.57 / $1,463.36 / $3,794.31	Facility		$450.57	$1,463.36	$3,794.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $328.92 / $450.57 / $6,147.14	Professional		$328.92	$450.57	$6,147.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $749.24 / $749.24 / $749.24	Professional		$749.24	$749.24	$749.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $598.22 / $749.24 / $749.24	Professional		$598.22	$749.24	$749.24
United Facility/Professional Professional Modifier Low / Median / High Price $298.48 / $399.37 / $815.83	Professional		$298.48	$399.37	$815.83