Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $488.18 / $488.18 / $488.18	Facility		$488.18	$488.18	$488.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.76 / $488.18 / $745.92	Professional		$392.76	$488.18	$745.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $967.72 / $1,064.49 / $1,761.25	Facility		$967.72	$1,064.49	$1,761.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.94 / $899.98 / $1,190.29	Professional		$870.94	$899.98	$1,190.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $696.18 / $2,070.92 / $2,070.92	Facility		$696.18	$2,070.92	$2,070.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $626.01 / $2,000.93 / $4,039.14	Facility		$626.01	$2,000.93	$4,039.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.99 / $1,402.50 / $1,831.49	Professional		$456.99	$1,402.50	$1,831.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $243.51 / $732.27 / $1,112.88	Facility		$243.51	$732.27	$1,112.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $554.10 / $967.72 / $1,161.26	Professional		$554.10	$967.72	$1,161.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $421.53 / $967.72 / $4,031.07	Facility		$421.53	$967.72	$4,031.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $377.20 / $482.78 / $1,053.73	Professional		$377.20	$482.78	$1,053.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $568.58	Professional		$50.00	$70.00	$568.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $243.51 / $732.27 / $1,112.88	Facility		$243.51	$732.27	$1,112.88
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $554.10 / $967.72 / $1,161.26	Professional		$554.10	$967.72	$1,161.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $967.72 / $1,451.58 / $2,263.34	Professional		$967.72	$1,451.58	$2,263.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $626.01 / $1,890.08 / $4,031.07	Facility		$626.01	$1,890.08	$4,031.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $456.99 / $626.01 / $5,197.82	Professional		$456.99	$626.01	$5,197.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $967.72 / $967.72 / $967.72	Professional		$967.72	$967.72	$967.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $967.72 / $967.72 / $967.72	Professional		$967.72	$967.72	$967.72
United Facility/Professional Professional Modifier Low / Median / High Price $321.86 / $482.78 / $925.34	Professional		$321.86	$482.78	$925.34