Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $294.04 / $294.04 / $294.04	Facility		$294.04	$294.04	$294.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.31 / $294.04 / $523.42	Professional		$278.31	$294.04	$523.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $582.88 / $641.16 / $1,060.83	Facility		$582.88	$641.16	$1,060.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $519.29 / $542.08 / $716.94	Professional		$519.29	$542.08	$716.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $419.32 / $1,247.35 / $1,247.35	Facility		$419.32	$1,247.35	$1,247.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $325.37 / $1,287.35 / $2,432.44	Facility		$325.37	$1,287.35	$2,432.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.37 / $682.51 / $1,103.15	Professional		$325.37	$682.51	$1,103.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $167.71 / $464.02 / $670.31	Facility		$167.71	$464.02	$670.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $333.75 / $568.90 / $699.46	Professional		$333.75	$568.90	$699.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $294.04 / $638.03 / $2,714.31	Facility		$294.04	$638.03	$2,714.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.45 / $305.33 / $634.69	Professional		$257.45	$305.33	$634.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $384.27	Professional		$50.00	$65.00	$384.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $167.71 / $466.30 / $670.31	Facility		$167.71	$466.30	$670.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $333.75 / $568.90 / $699.46	Professional		$333.75	$568.90	$699.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $582.88 / $897.05 / $1,558.75	Professional		$582.88	$897.05	$1,558.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $325.37 / $1,138.44 / $2,714.31	Facility		$325.37	$1,138.44	$2,714.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $237.52 / $325.37 / $2,934.66	Professional		$237.52	$325.37	$2,934.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $582.88 / $582.88 / $582.88	Professional		$582.88	$582.88	$582.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $582.88 / $582.88 / $582.88	Professional		$582.88	$582.88	$582.88
United Facility/Professional Professional Modifier Low / Median / High Price $216.48 / $290.80 / $516.79	Professional		$216.48	$290.80	$516.79