Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $266.02 / $266.02 / $266.02	Facility		$266.02	$266.02	$266.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.69 / $266.02 / $443.30	Professional		$219.69	$266.02	$443.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $527.36 / $580.10 / $959.80	Facility		$527.36	$580.10	$959.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $474.62 / $490.44 / $648.65	Professional		$474.62	$490.44	$648.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $379.38 / $1,128.55 / $1,128.55	Facility		$379.38	$1,128.55	$1,128.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $329.53 / $1,090.05 / $2,201.51	Facility		$329.53	$1,090.05	$2,201.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.56 / $764.06 / $998.08	Professional		$240.56	$764.06	$998.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $169.85 / $399.05 / $606.46	Facility		$169.85	$399.05	$606.46
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $301.95 / $527.36 / $632.83	Professional		$301.95	$527.36	$632.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $266.02 / $527.36 / $2,777.21	Facility		$266.02	$527.36	$2,777.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $245.20 / $352.37 / $580.10	Professional		$245.20	$352.37	$580.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $355.89	Professional		$50.00	$70.00	$355.89
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $169.85 / $407.03 / $606.46	Facility		$169.85	$407.03	$606.46
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $301.95 / $527.36 / $632.83	Professional		$301.95	$527.36	$632.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $527.36 / $811.59 / $1,578.82	Professional		$527.36	$811.59	$1,578.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $329.53 / $1,030.00 / $2,777.21	Facility		$329.53	$1,030.00	$2,777.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $240.56 / $329.53 / $3,480.59	Professional		$240.56	$329.53	$3,480.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $527.36 / $527.36 / $527.36	Professional		$527.36	$527.36	$527.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $527.36 / $527.36 / $527.36	Professional		$527.36	$527.36	$527.36
United Facility/Professional Professional Modifier Low / Median / High Price $210.10 / $347.66 / $467.57	Professional		$210.10	$347.66	$467.57