Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.02 / $349.02 / $349.02	Facility		$349.02	$349.02	$349.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $264.61 / $349.02 / $579.51	Professional		$264.61	$349.02	$579.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.87 / $761.06 / $1,259.20	Facility		$691.87	$761.06	$1,259.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $598.39 / $643.44 / $851.00	Professional		$598.39	$643.44	$851.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $497.73 / $1,480.60 / $1,480.60	Facility		$497.73	$1,480.60	$1,480.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $459.90 / $1,430.59 / $2,887.30	Facility		$459.90	$1,430.59	$2,887.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.73 / $1,152.28 / $1,309.41	Professional		$335.73	$1,152.28	$1,309.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $195.32 / $523.53 / $795.65	Facility		$195.32	$523.53	$795.65
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $396.14 / $691.87 / $830.24	Professional		$396.14	$691.87	$830.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $338.10 / $691.87 / $3,120.86	Facility		$338.10	$691.87	$3,120.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $311.64 / $455.84 / $753.36	Professional		$311.64	$455.84	$753.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $409.25	Professional		$50.00	$70.00	$409.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $195.32 / $523.53 / $795.65	Facility		$195.32	$523.53	$795.65
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $396.14 / $691.87 / $830.24	Professional		$396.14	$691.87	$830.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $691.87 / $1,064.74 / $1,815.69	Professional		$691.87	$1,064.74	$1,815.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $459.90 / $1,351.30 / $3,120.86	Facility		$459.90	$1,351.30	$3,120.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $335.73 / $459.90 / $4,002.47	Professional		$335.73	$459.90	$4,002.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $691.87 / $691.87 / $691.87	Professional		$691.87	$691.87	$691.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $691.87 / $691.87 / $691.87	Professional		$691.87	$691.87	$691.87
United Facility/Professional Professional Modifier Low / Median / High Price $273.44 / $415.12 / $691.87	Professional		$273.44	$415.12	$691.87