Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $372.66 / $372.66 / $372.66	Facility		$372.66	$372.66	$372.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $270.12 / $372.66 / $513.29	Professional		$270.12	$372.66	$513.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $738.73 / $812.60 / $1,344.49	Facility		$738.73	$812.60	$1,344.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $664.85 / $687.02 / $908.63	Professional		$664.85	$687.02	$908.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $531.44 / $1,580.88 / $1,580.88	Facility		$531.44	$1,580.88	$1,580.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $477.88 / $1,527.20 / $3,083.24	Facility		$477.88	$1,527.20	$3,083.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $348.85 / $1,230.33 / $1,398.11	Professional		$348.85	$1,230.33	$1,398.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $183.20 / $558.99 / $849.54	Facility		$183.20	$558.99	$849.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $422.99 / $738.73 / $886.48	Professional		$422.99	$738.73	$886.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $317.12 / $738.73 / $3,084.21	Facility		$317.12	$738.73	$3,084.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.23 / $368.54 / $804.39	Professional		$281.23	$368.54	$804.39
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 $183.20 / $558.99 / $849.54	Facility		$183.20	$558.99	$849.54
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $422.99 / $738.73 / $886.48	Professional		$422.99	$738.73	$886.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $738.73 / $1,108.09 / $1,702.28	Professional		$738.73	$1,108.09	$1,702.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $477.88 / $1,442.84 / $3,084.21	Facility		$477.88	$1,442.84	$3,084.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $348.85 / $477.88 / $3,708.18	Professional		$348.85	$477.88	$3,708.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $738.73 / $738.73 / $738.73	Professional		$738.73	$738.73	$738.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $738.73 / $738.73 / $738.73	Professional		$738.73	$738.73	$738.73
United Facility/Professional Professional Modifier Low / Median / High Price $245.70 / $368.54 / $706.38	Professional		$245.70	$368.54	$706.38