Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $249.94 / $249.94 / $249.94	Facility		$249.94	$249.94	$249.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.88 / $249.94 / $419.48	Professional		$220.88	$249.94	$419.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $495.46 / $545.01 / $901.74	Facility		$495.46	$545.01	$901.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $445.91 / $460.78 / $609.41	Professional		$445.91	$460.78	$609.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $356.44 / $1,060.28 / $1,060.28	Facility		$356.44	$1,060.28	$1,060.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $290.63 / $1,024.39 / $2,068.56	Facility		$290.63	$1,024.39	$2,068.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.16 / $718.13 / $937.70	Professional		$212.16	$718.13	$937.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $149.80 / $374.91 / $569.78	Facility		$149.80	$374.91	$569.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $283.70 / $495.46 / $620.13	Professional		$283.70	$495.46	$620.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $249.94 / $495.46 / $2,531.55	Facility		$249.94	$495.46	$2,531.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $214.54 / $270.70 / $559.39	Professional		$214.54	$270.70	$559.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $219.32	Professional		$50.00	$70.00	$219.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $149.80 / $374.91 / $569.78	Facility		$149.80	$374.91	$569.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $283.70 / $495.46 / $620.13	Professional		$283.70	$495.46	$620.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $495.46 / $762.53 / $1,392.13	Professional		$495.46	$762.53	$1,392.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $290.63 / $967.70 / $2,531.55	Facility		$290.63	$967.70	$2,531.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $212.16 / $290.63 / $4,350.60	Professional		$212.16	$290.63	$4,350.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $495.46 / $495.46 / $495.46	Professional		$495.46	$495.46	$495.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $495.46 / $495.46 / $495.46	Professional		$495.46	$495.46	$495.46
United Facility/Professional Facility Modifier Low / Median / High Price $444.22 / $444.22 / $444.22	Facility		$444.22	$444.22	$444.22
United Facility/Professional Professional Modifier Low / Median / High Price $193.37 / $257.61 / $473.78	Professional		$193.37	$257.61	$473.78