Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $481.63 / $481.63 / $481.63	Facility		$481.63	$481.63	$481.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $397.72 / $481.63 / $802.57	Professional		$397.72	$481.63	$802.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $954.75 / $1,050.23 / $1,737.65	Facility		$954.75	$1,050.23	$1,737.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $887.92 / $887.92 / $1,174.33	Professional		$887.92	$887.92	$1,174.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $686.83 / $2,043.17 / $2,043.17	Facility		$686.83	$2,043.17	$2,043.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $596.58 / $1,973.71 / $3,984.56	Facility		$596.58	$1,973.71	$3,984.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $435.50 / $1,590.11 / $1,806.94	Professional		$435.50	$1,590.11	$1,806.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $307.50 / $722.45 / $1,097.96	Facility		$307.50	$722.45	$1,097.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $546.66 / $954.75 / $1,273.00	Professional		$546.66	$954.75	$1,273.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $481.63 / $954.75 / $5,050.38	Facility		$481.63	$954.75	$5,050.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $443.91 / $637.92 / $1,077.88	Professional		$443.91	$637.92	$1,077.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $593.04	Professional		$50.00	$70.00	$593.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $307.50 / $736.89 / $1,097.96	Facility		$307.50	$736.89	$1,097.96
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $546.66 / $954.75 / $1,273.00	Professional		$546.66	$954.75	$1,273.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $954.75 / $1,469.32 / $2,857.53	Professional		$954.75	$1,469.32	$2,857.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $596.58 / $1,864.74 / $5,050.38	Facility		$596.58	$1,864.74	$5,050.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $435.50 / $596.58 / $6,402.83	Professional		$435.50	$596.58	$6,402.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $954.75 / $954.75 / $954.75	Professional		$954.75	$954.75	$954.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $762.33 / $954.75 / $954.75	Professional		$762.33	$954.75	$954.75
United Facility/Professional Facility Modifier Low / Median / High Price $0.76 / $716.78 / $733.98	Facility		$0.76	$716.78	$733.98
United Facility/Professional Professional Modifier Low / Median / High Price $380.36 / $635.08 / $924.33	Professional		$380.36	$635.08	$924.33