Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $413.62 / $413.62 / $413.62	Facility		$413.62	$413.62	$413.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.77 / $413.62 / $686.76	Professional		$309.77	$413.62	$686.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $819.92 / $901.91 / $1,492.25	Facility		$819.92	$901.91	$1,492.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $737.92 / $762.53 / $1,008.50	Professional		$737.92	$762.53	$1,008.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $589.85 / $1,754.63 / $1,754.63	Facility		$589.85	$1,754.63	$1,754.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $530.41 / $1,695.12 / $3,421.93	Facility		$530.41	$1,695.12	$3,421.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $387.20 / $1,365.55 / $1,551.76	Professional		$387.20	$1,365.55	$1,551.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $239.50 / $620.42 / $942.91	Facility		$239.50	$620.42	$942.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $469.48 / $743.63 / $983.90	Professional		$469.48	$743.63	$983.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $413.62 / $819.92 / $3,873.08	Facility		$413.62	$819.92	$3,873.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $370.99 / $547.86 / $892.79	Professional		$370.99	$547.86	$892.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $553.34	Professional		$50.00	$70.00	$553.34
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $239.50 / $620.42 / $942.91	Facility		$239.50	$620.42	$942.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $469.48 / $743.63 / $983.90	Professional		$469.48	$743.63	$983.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $819.92 / $1,261.82 / $2,226.21	Professional		$819.92	$1,261.82	$2,226.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $530.41 / $1,601.40 / $3,873.08	Facility		$530.41	$1,601.40	$3,873.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $387.20 / $530.41 / $4,937.72	Professional		$387.20	$530.41	$4,937.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $819.92 / $819.92 / $819.92	Professional		$819.92	$819.92	$819.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $819.92 / $819.92 / $819.92	Professional		$819.92	$819.92	$819.92
United Facility/Professional Professional Modifier Low / Median / High Price $322.97 / $494.65 / $726.95	Professional		$322.97	$494.65	$726.95