Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $392.88 / $392.88 / $392.88	Facility		$392.88	$392.88	$392.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.61 / $392.88 / $652.33	Professional		$251.61	$392.88	$652.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $778.81 / $856.69 / $1,417.43	Facility		$778.81	$856.69	$1,417.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $673.58 / $724.29 / $957.93	Professional		$673.58	$724.29	$957.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $560.28 / $1,666.65 / $1,666.65	Facility		$560.28	$1,666.65	$1,666.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $503.81 / $1,609.75 / $3,251.19	Facility		$503.81	$1,609.75	$3,251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $367.78 / $1,297.08 / $1,473.96	Professional		$367.78	$1,297.08	$1,473.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $188.13 / $589.32 / $895.63	Facility		$188.13	$589.32	$895.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $445.94 / $778.81 / $934.57	Professional		$445.94	$778.81	$934.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $325.66 / $772.35 / $3,083.04	Facility		$325.66	$772.35	$3,083.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $310.27 / $439.06 / $848.02	Professional		$310.27	$439.06	$848.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $485.05	Professional		$50.00	$70.00	$485.05
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $188.13 / $589.32 / $895.63	Facility		$188.13	$589.32	$895.63
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $445.94 / $778.81 / $934.57	Professional		$445.94	$778.81	$934.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $778.81 / $1,168.22 / $1,748.45	Professional		$778.81	$1,168.22	$1,748.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $503.81 / $1,521.12 / $3,083.04	Facility		$503.81	$1,521.12	$3,083.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $367.78 / $503.81 / $3,878.47	Professional		$367.78	$503.81	$3,878.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $778.81 / $778.81 / $778.81	Professional		$778.81	$778.81	$778.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $778.81 / $778.81 / $778.81	Professional		$778.81	$778.81	$778.81
United Facility/Professional Facility Modifier Low / Median / High Price $388.77 / $388.77 / $388.77	Facility		$388.77	$388.77	$388.77
United Facility/Professional Professional Modifier Low / Median / High Price $259.02 / $407.97 / $690.50	Professional		$259.02	$407.97	$690.50