Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $399.02 / $399.02 / $399.02	Facility		$399.02	$399.02	$399.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.02 / $439.65 / $853.38	Professional		$399.02	$439.65	$853.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $790.98 / $870.08 / $1,439.58	Facility		$790.98	$870.08	$1,439.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $711.88 / $735.61 / $972.90	Professional		$711.88	$735.61	$972.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $569.03 / $1,692.70 / $1,692.70	Facility		$569.03	$1,692.70	$1,692.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $494.25 / $1,635.06 / $3,301.57	Facility		$494.25	$1,635.06	$3,301.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $360.80 / $1,146.08 / $1,496.99	Professional		$360.80	$1,146.08	$1,496.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $254.75 / $598.53 / $909.63	Facility		$254.75	$598.53	$909.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $452.90 / $790.98 / $1,054.64	Professional		$452.90	$790.98	$1,054.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $399.02 / $830.53 / $4,154.25	Facility		$399.02	$830.53	$4,154.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $358.31 / $460.60 / $893.01	Professional		$358.31	$460.60	$893.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $490.36	Professional		$50.00	$70.00	$490.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $254.75 / $598.53 / $909.63	Facility		$254.75	$598.53	$909.63
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $452.90 / $790.98 / $1,054.64	Professional		$452.90	$790.98	$1,054.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $790.98 / $1,217.30 / $2,367.73	Professional		$790.98	$1,217.30	$2,367.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $494.25 / $1,544.88 / $4,154.25	Facility		$494.25	$1,544.88	$4,154.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $360.80 / $494.25 / $5,062.27	Professional		$360.80	$494.25	$5,062.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $790.98 / $790.98 / $790.98	Professional		$790.98	$790.98	$790.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $631.58 / $790.98 / $790.98	Professional		$631.58	$790.98	$790.98
United Facility/Professional Professional Modifier Low / Median / High Price $308.98 / $421.12 / $756.34	Professional		$308.98	$421.12	$756.34