Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.01 / $288.01 / $288.01	Facility		$288.01	$288.01	$288.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.69 / $288.01 / $478.21	Professional		$204.69	$288.01	$478.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $570.92 / $628.02 / $1,039.08	Facility		$570.92	$628.02	$1,039.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $493.79 / $530.96 / $702.24	Professional		$493.79	$530.96	$702.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $410.72 / $1,221.79 / $1,221.79	Facility		$410.72	$1,221.79	$1,221.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $305.54 / $1,180.10 / $2,383.46	Facility		$305.54	$1,180.10	$2,383.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.04 / $827.34 / $1,080.54	Professional		$223.04	$827.34	$1,080.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $157.49 / $432.02 / $656.57	Facility		$157.49	$432.02	$656.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $326.91 / $488.98 / $685.12	Professional		$326.91	$488.98	$685.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $272.62 / $570.92 / $2,506.23	Facility		$272.62	$570.92	$2,506.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.18 / $367.48 / $621.66	Professional		$257.18	$367.48	$621.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $330.00	Professional		$50.00	$70.00	$330.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $157.49 / $432.02 / $656.57	Facility		$157.49	$432.02	$656.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $326.91 / $488.98 / $685.12	Professional		$326.91	$488.98	$685.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $570.92 / $878.66 / $1,463.39	Professional		$570.92	$878.66	$1,463.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $305.54 / $1,115.09 / $2,506.23	Facility		$305.54	$1,115.09	$2,506.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $223.04 / $305.54 / $3,227.30	Professional		$223.04	$305.54	$3,227.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $570.92 / $570.92 / $570.92	Professional		$570.92	$570.92	$570.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $570.92 / $570.92 / $570.92	Professional		$570.92	$570.92	$570.92
United Facility/Professional Facility Modifier Low / Median / High Price $244.40 / $244.40 / $244.40	Facility		$244.40	$244.40	$244.40
United Facility/Professional Professional Modifier Low / Median / High Price $203.29 / $367.11 / $621.66	Professional		$203.29	$367.11	$621.66