Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $501.32 / $501.32 / $501.32	Facility		$501.32	$501.32	$501.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $498.52 / $501.32 / $946.78	Professional		$498.52	$501.32	$946.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $993.78 / $1,093.16 / $1,808.68	Facility		$993.78	$1,093.16	$1,808.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $894.40 / $924.22 / $1,222.33	Professional		$894.40	$924.22	$1,222.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $714.92 / $2,126.69 / $2,126.69	Facility		$714.92	$2,126.69	$2,126.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $620.97 / $2,054.39 / $4,148.31	Facility		$620.97	$2,054.39	$4,148.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $453.31 / $1,440.00 / $1,880.81	Professional		$453.31	$1,440.00	$1,880.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $320.07 / $751.98 / $1,142.84	Facility		$320.07	$751.98	$1,142.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $569.02 / $993.78 / $1,325.04	Professional		$569.02	$993.78	$1,325.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $501.32 / $993.78 / $5,297.15	Facility		$501.32	$993.78	$5,297.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $450.17 / $589.73 / $1,121.96	Professional		$450.17	$589.73	$1,121.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $255.18	Professional		$50.00	$70.00	$255.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $320.07 / $751.98 / $1,142.84	Facility		$320.07	$751.98	$1,142.84
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $569.02 / $993.78 / $1,325.04	Professional		$569.02	$993.78	$1,325.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $993.78 / $1,529.37 / $2,974.97	Professional		$993.78	$1,529.37	$2,974.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $620.97 / $1,940.98 / $5,297.15	Facility		$620.97	$1,940.98	$5,297.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $453.31 / $620.97 / $6,629.67	Professional		$453.31	$620.97	$6,629.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $993.78 / $993.78 / $993.78	Professional		$993.78	$993.78	$993.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $804.30 / $993.78 / $993.78	Professional		$804.30	$993.78	$993.78
United Facility/Professional Professional Modifier Low / Median / High Price $388.20 / $529.09 / $950.26	Professional		$388.20	$529.09	$950.26