Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $433.21 / $498.19 / $542.52	Facility		$433.21	$498.19	$542.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $414.54 / $433.21 / $787.29	Professional		$414.54	$433.21	$787.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $858.76 / $944.64 / $1,562.94	Facility		$858.76	$944.64	$1,562.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $773.50 / $798.65 / $1,056.27	Professional		$773.50	$798.65	$1,056.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $617.78 / $1,837.75 / $1,837.75	Facility		$617.78	$1,837.75	$1,837.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $579.51 / $1,896.48 / $3,584.28	Facility		$579.51	$1,896.48	$3,584.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $579.51 / $1,025.49 / $1,625.26	Professional		$579.51	$1,025.49	$1,625.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $262.32 / $741.54 / $987.57	Facility		$262.32	$741.54	$987.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $491.71 / $858.76 / $1,037.93	Professional		$491.71	$858.76	$1,037.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $433.21 / $895.92 / $4,272.47	Facility		$433.21	$895.92	$4,272.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $386.83 / $500.92 / $1,034.60	Professional		$386.83	$500.92	$1,034.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $378.13	Professional		$50.00	$70.00	$378.13
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $262.32 / $741.54 / $987.57	Facility		$262.32	$741.54	$987.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $491.71 / $858.76 / $1,037.93	Professional		$491.71	$858.76	$1,037.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $858.76 / $1,321.59 / $2,437.98	Professional		$858.76	$1,321.59	$2,437.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $579.51 / $1,677.26 / $4,272.47	Facility		$579.51	$1,677.26	$4,272.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $423.04 / $579.51 / $4,982.06	Professional		$423.04	$579.51	$4,982.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $858.76 / $858.76 / $858.76	Professional		$858.76	$858.76	$858.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $858.76 / $858.76 / $858.76	Professional		$858.76	$858.76	$858.76
United Facility/Professional Professional Modifier Low / Median / High Price $338.61 / $483.33 / $935.08	Professional		$338.61	$483.33	$935.08