Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $310.86 / $413.95 / $805.35	Facility		$310.86	$413.95	$805.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $413.95 / $428.97 / $933.34	Professional		$413.95	$428.97	$933.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $820.58 / $902.64 / $1,493.46	Facility		$820.58	$902.64	$1,493.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $763.14 / $763.14 / $1,009.31	Professional		$763.14	$763.14	$1,009.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $590.32 / $1,756.04 / $1,756.04	Facility		$590.32	$1,756.04	$1,756.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $488.53 / $1,811.32 / $3,424.73	Facility		$488.53	$1,811.32	$3,424.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $488.53 / $979.92 / $1,553.01	Professional		$488.53	$979.92	$1,553.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $232.26 / $700.27 / $943.67	Facility		$232.26	$700.27	$943.67
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $469.85 / $820.58 / $984.70	Professional		$469.85	$820.58	$984.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $413.95 / $852.10 / $3,743.02	Facility		$413.95	$852.10	$3,743.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $359.77 / $469.85 / $979.86	Professional		$359.77	$469.85	$979.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $159.86	Professional		$50.00	$70.00	$159.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $232.26 / $700.27 / $943.67	Facility		$232.26	$700.27	$943.67
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $469.85 / $820.58 / $984.70	Professional		$469.85	$820.58	$984.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $820.58 / $1,262.84 / $2,158.96	Professional		$820.58	$1,262.84	$2,158.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $488.53 / $1,602.70 / $3,743.02	Facility		$488.53	$1,602.70	$3,743.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $356.63 / $488.53 / $4,332.34	Professional		$356.63	$488.53	$4,332.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $820.58 / $820.58 / $820.58	Professional		$820.58	$820.58	$820.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $820.58 / $820.58 / $820.58	Professional		$820.58	$820.58	$820.58
United Facility/Professional Professional Modifier Low / Median / High Price $281.70 / $409.38 / $893.51	Professional		$281.70	$409.38	$893.51