Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $357.62 / $357.62 / $357.62	Facility		$357.62	$357.62	$357.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.32 / $357.62 / $595.91	Professional		$295.32	$357.62	$595.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $708.91 / $779.80 / $1,290.22	Facility		$708.91	$779.80	$1,290.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $638.01 / $659.29 / $871.95	Professional		$638.01	$659.29	$871.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $509.99 / $1,517.07 / $1,517.07	Facility		$509.99	$1,517.07	$1,517.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $458.59 / $1,465.28 / $2,958.68	Facility		$458.59	$1,465.28	$2,958.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.77 / $1,027.50 / $1,341.68	Professional		$334.77	$1,027.50	$1,341.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $228.32 / $536.42 / $815.25	Facility		$228.32	$536.42	$815.25
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $405.90 / $708.91 / $850.69	Professional		$405.90	$708.91	$850.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $357.62 / $708.91 / $3,692.24	Facility		$357.62	$708.91	$3,692.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $329.61 / $473.68 / $800.34	Professional		$329.61	$473.68	$800.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $478.42	Professional		$50.00	$70.00	$478.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $228.32 / $547.16 / $815.25	Facility		$228.32	$547.16	$815.25
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $405.90 / $708.91 / $850.69	Professional		$405.90	$708.91	$850.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $708.91 / $1,091.00 / $2,121.82	Professional		$708.91	$1,091.00	$2,121.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $458.59 / $1,384.60 / $3,692.24	Facility		$458.59	$1,384.60	$3,692.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $334.77 / $458.59 / $4,707.20	Professional		$334.77	$458.59	$4,707.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $708.91 / $708.91 / $708.91	Professional		$708.91	$708.91	$708.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $708.91 / $708.91 / $708.91	Professional		$708.91	$708.91	$708.91
United Facility/Professional Professional Modifier Low / Median / High Price $282.42 / $425.35 / $708.91	Professional		$282.42	$425.35	$708.91