Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $377.76 / $377.76 / $377.76	Facility		$377.76	$377.76	$377.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $272.72 / $377.76 / $627.23	Professional		$272.72	$377.76	$627.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $748.84 / $823.72 / $1,362.89	Facility		$748.84	$823.72	$1,362.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $647.66 / $696.42 / $921.07	Professional		$647.66	$696.42	$921.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $538.71 / $1,602.52 / $1,602.52	Facility		$538.71	$1,602.52	$1,602.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $484.42 / $1,547.83 / $3,125.23	Facility		$484.42	$1,547.83	$3,125.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.63 / $1,085.16 / $1,417.24	Professional		$353.63	$1,085.16	$1,417.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $210.79 / $566.64 / $861.17	Facility		$210.79	$566.64	$861.17
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $428.77 / $654.47 / $898.61	Professional		$428.77	$654.47	$898.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $364.88 / $748.84 / $3,319.62	Facility		$364.88	$748.84	$3,319.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $337.32 / $491.84 / $815.40	Professional		$337.32	$491.84	$815.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $441.67	Professional		$50.00	$70.00	$441.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $210.79 / $566.64 / $861.17	Facility		$210.79	$566.64	$861.17
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $428.77 / $654.47 / $898.61	Professional		$428.77	$654.47	$898.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $748.84 / $1,152.44 / $1,959.22	Professional		$748.84	$1,152.44	$1,959.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $484.42 / $1,462.58 / $3,319.62	Facility		$484.42	$1,462.58	$3,319.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $353.63 / $484.42 / $4,319.52	Professional		$353.63	$484.42	$4,319.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $748.84 / $748.84 / $748.84	Professional		$748.84	$748.84	$748.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $748.84 / $748.84 / $748.84	Professional		$748.84	$748.84	$748.84
United Facility/Professional Professional Modifier Low / Median / High Price $255.66 / $435.34 / $748.84	Professional		$255.66	$435.34	$748.84