Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $333.09 / $333.09 / $333.09	Facility		$333.09	$333.09	$333.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.61 / $333.09 / $553.05	Professional		$251.61	$333.09	$553.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $660.30 / $726.33 / $1,201.75	Facility		$660.30	$726.33	$1,201.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $614.08 / $614.08 / $812.16	Professional		$614.08	$614.08	$812.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $475.02 / $1,413.04 / $1,413.04	Facility		$475.02	$1,413.04	$1,413.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $427.13 / $1,364.92 / $2,755.74	Facility		$427.13	$1,364.92	$2,755.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.80 / $956.72 / $1,249.66	Professional		$311.80	$956.72	$1,249.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $194.53 / $499.64 / $759.35	Facility		$194.53	$499.64	$759.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $378.06 / $660.30 / $792.36	Professional		$378.06	$660.30	$792.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $333.09 / $660.30 / $3,226.39	Facility		$333.09	$660.30	$3,226.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $305.36 / $441.19 / $745.46	Professional		$305.36	$441.19	$745.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $416.51	Professional		$50.00	$70.00	$416.51
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $194.53 / $499.64 / $759.35	Facility		$194.53	$499.64	$759.35
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $378.06 / $660.30 / $792.36	Professional		$378.06	$660.30	$792.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $660.30 / $1,016.18 / $1,807.66	Professional		$660.30	$1,016.18	$1,807.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $427.13 / $1,289.64 / $3,226.39	Facility		$427.13	$1,289.64	$3,226.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $311.80 / $427.13 / $3,986.28	Professional		$311.80	$427.13	$3,986.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $660.30 / $660.30 / $660.30	Professional		$660.30	$660.30	$660.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $660.30 / $660.30 / $660.30	Professional		$660.30	$660.30	$660.30
United Facility/Professional Professional Modifier Low / Median / High Price $263.05 / $401.76 / $660.30	Professional		$263.05	$401.76	$660.30