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 / $528.57	Professional		$278.31	$294.04	$528.57
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 $524.59 / $542.08 / $716.94	Professional		$524.59	$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 / $1,232.25 / $2,432.44	Facility		$325.37	$1,232.25	$2,432.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.52 / $970.77 / $1,103.15	Professional		$237.52	$970.77	$1,103.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $78.06 / $441.06 / $670.31	Facility		$78.06	$441.06	$670.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $568.90 / $582.88 / $699.46	Professional		$568.90	$582.88	$699.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.64 / $582.88 / $2,714.31	Facility		$107.64	$582.88	$2,714.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $264.89 / $309.00 / $649.44	Professional		$264.89	$309.00	$649.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.40 / $57.81 / $85.00	Professional		$47.40	$57.81	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $107.42 / $441.06 / $670.31	Facility		$107.42	$441.06	$670.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $568.90 / $582.88 / $699.46	Professional		$568.90	$582.88	$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 $107.64 / $1,138.44 / $2,714.31	Facility		$107.64	$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 $232.22 / $298.14 / $582.88	Professional		$232.22	$298.14	$582.88