Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $291.33 / $291.33 / $291.33	Facility		$291.33	$291.33	$291.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $291.33 / $312.26 / $593.03	Professional		$291.33	$312.26	$593.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $577.50 / $635.25 / $1,051.05	Facility		$577.50	$635.25	$1,051.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.08 / $537.08 / $710.32	Professional		$537.08	$537.08	$710.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $415.45 / $1,235.84 / $1,235.84	Facility		$415.45	$1,235.84	$1,235.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $373.57 / $1,194.17 / $2,410.05	Facility		$373.57	$1,194.17	$2,410.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.70 / $836.72 / $1,092.95	Professional		$272.70	$836.72	$1,092.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $180.02 / $437.00 / $664.13	Facility		$180.02	$437.00	$664.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $330.66 / $577.50 / $745.25	Professional		$330.66	$577.50	$745.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $291.33 / $606.38 / $2,938.67	Facility		$291.33	$606.38	$2,938.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $260.14 / $325.33 / $651.97	Professional		$260.14	$325.33	$651.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $337.42	Professional		$50.00	$70.00	$337.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $180.02 / $437.00 / $664.13	Facility		$180.02	$437.00	$664.13
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $330.66 / $577.50 / $745.25	Professional		$330.66	$577.50	$745.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $577.50 / $888.76 / $1,673.17	Professional		$577.50	$888.76	$1,673.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $373.57 / $1,127.92 / $2,938.67	Facility		$373.57	$1,127.92	$2,938.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $272.70 / $373.57 / $3,688.99	Professional		$272.70	$373.57	$3,688.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $577.50 / $577.50 / $577.50	Professional		$577.50	$577.50	$577.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $577.50 / $577.50 / $577.50	Professional		$577.50	$577.50	$577.50
United Facility/Professional Facility Modifier Low / Median / High Price $0.45 / $276.36 / $364.85	Facility		$0.45	$276.36	$364.85
United Facility/Professional Professional Modifier Low / Median / High Price $230.07 / $307.41 / $552.21	Professional		$230.07	$307.41	$552.21