Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $268.43 / $268.43 / $268.43	Facility		$268.43	$268.43	$268.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.90 / $268.43 / $445.69	Professional		$208.90	$268.43	$445.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $532.11 / $585.32 / $968.44	Facility		$532.11	$585.32	$968.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.89 / $494.86 / $654.49	Professional		$478.89	$494.86	$654.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $382.80 / $1,138.72 / $1,138.72	Facility		$382.80	$1,138.72	$1,138.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $344.22 / $1,100.34 / $2,221.11	Facility		$344.22	$1,100.34	$2,221.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.28 / $771.09 / $1,007.06	Professional		$251.28	$771.09	$1,007.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $161.51 / $402.65 / $611.92	Facility		$161.51	$402.65	$611.92
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $304.67 / $501.48 / $638.53	Professional		$304.67	$501.48	$638.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $268.43 / $532.11 / $2,561.73	Facility		$268.43	$532.11	$2,561.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $247.40 / $355.54 / $579.40	Professional		$247.40	$355.54	$579.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $342.71	Professional		$50.00	$70.00	$342.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $161.51 / $402.65 / $611.92	Facility		$161.51	$402.65	$611.92
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $304.67 / $501.48 / $638.53	Professional		$304.67	$501.48	$638.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $532.11 / $818.89 / $1,501.54	Professional		$532.11	$818.89	$1,501.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $344.22 / $1,039.28 / $2,561.73	Facility		$344.22	$1,039.28	$2,561.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $251.28 / $344.22 / $3,309.77	Professional		$251.28	$344.22	$3,309.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $532.11 / $532.11 / $532.11	Professional		$532.11	$532.11	$532.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $532.11 / $532.11 / $532.11	Professional		$532.11	$532.11	$532.11
United Facility/Professional Professional Modifier Low / Median / High Price $208.49 / $333.58 / $532.11	Professional		$208.49	$333.58	$532.11