Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $441.18 / $441.18 / $441.18	Facility		$441.18	$441.18	$441.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $431.55 / $486.62 / $819.59	Professional		$431.55	$486.62	$819.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $874.56 / $962.02 / $1,591.70	Facility		$874.56	$962.02	$1,591.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $813.34 / $813.34 / $1,075.70	Professional		$813.34	$813.34	$1,075.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $629.16 / $1,871.56 / $1,871.56	Facility		$629.16	$1,871.56	$1,871.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $510.00 / $1,807.67 / $3,650.06	Facility		$510.00	$1,807.67	$3,650.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $372.30 / $1,267.50 / $1,655.16	Professional		$372.30	$1,267.50	$1,655.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $260.95 / $657.36 / $1,005.74	Facility		$260.95	$657.36	$1,005.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $500.75 / $874.56 / $1,080.27	Professional		$500.75	$874.56	$1,080.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $441.18 / $874.56 / $4,248.13	Facility		$441.18	$874.56	$4,248.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $393.95 / $480.80 / $976.82	Professional		$393.95	$480.80	$976.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $395.42	Professional		$50.00	$70.00	$395.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $260.95 / $661.77 / $1,005.74	Facility		$260.95	$661.77	$1,005.74
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $500.75 / $874.56 / $1,080.27	Professional		$500.75	$874.56	$1,080.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $874.56 / $1,345.94 / $2,424.94	Professional		$874.56	$1,345.94	$2,424.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $510.00 / $1,708.12 / $4,248.13	Facility		$510.00	$1,708.12	$4,248.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $372.30 / $510.00 / $5,185.30	Professional		$372.30	$510.00	$5,185.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $874.56 / $874.56 / $874.56	Professional		$874.56	$874.56	$874.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $698.32 / $874.56 / $874.56	Professional		$698.32	$874.56	$874.56
United Facility/Professional Professional Modifier Low / Median / High Price $336.84 / $436.31 / $775.40	Professional		$336.84	$436.31	$775.40