Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.77 / $389.77 / $389.77	Facility		$389.77	$389.77	$389.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.90 / $389.77 / $647.16	Professional		$254.90	$389.77	$647.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $772.66 / $849.93 / $1,406.24	Facility		$772.66	$849.93	$1,406.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $695.39 / $718.57 / $950.37	Professional		$695.39	$718.57	$950.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $555.85 / $1,653.49 / $1,653.49	Facility		$555.85	$1,653.49	$1,653.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $499.82 / $1,597.55 / $3,224.60	Facility		$499.82	$1,597.55	$3,224.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.87 / $1,119.83 / $1,462.31	Professional		$364.87	$1,119.83	$1,462.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $186.64 / $584.66 / $888.56	Facility		$186.64	$584.66	$888.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $442.41 / $580.19 / $927.19	Professional		$442.41	$580.19	$927.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $323.08 / $772.66 / $3,076.44	Facility		$323.08	$772.66	$3,076.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $307.82 / $442.41 / $841.32	Professional		$307.82	$442.41	$841.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $391.08	Professional		$50.00	$70.00	$391.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $186.64 / $584.66 / $888.56	Facility		$186.64	$584.66	$888.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $442.41 / $580.19 / $927.19	Professional		$442.41	$580.19	$927.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $772.66 / $1,158.99 / $1,734.39	Professional		$772.66	$1,158.99	$1,734.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $499.82 / $1,509.10 / $3,076.44	Facility		$499.82	$1,509.10	$3,076.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $364.87 / $499.82 / $3,592.02	Professional		$364.87	$499.82	$3,592.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $772.66 / $772.66 / $772.66	Professional		$772.66	$772.66	$772.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $772.66 / $772.66 / $772.66	Professional		$772.66	$772.66	$772.66
United Facility/Professional Facility Modifier Low / Median / High Price $0.46 / $435.06 / $435.59	Facility		$0.46	$435.06	$435.59
United Facility/Professional Professional Modifier Low / Median / High Price $261.30 / $435.06 / $722.76	Professional		$261.30	$435.06	$722.76