Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $411.88 / $411.88 / $411.88	Facility		$411.88	$411.88	$411.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.99 / $411.88 / $683.87	Professional		$290.99	$411.88	$683.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $816.48 / $898.13 / $1,485.99	Facility		$816.48	$898.13	$1,485.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $759.33 / $759.33 / $1,004.27	Professional		$759.33	$759.33	$1,004.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $587.37 / $1,747.27 / $1,747.27	Facility		$587.37	$1,747.27	$1,747.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $555.76 / $1,687.60 / $3,407.94	Facility		$555.76	$1,687.60	$3,407.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $405.70 / $1,183.13 / $1,545.25	Professional		$405.70	$1,183.13	$1,545.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $224.98 / $617.82 / $938.95	Facility		$224.98	$617.82	$938.95
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $467.47 / $781.94 / $979.78	Professional		$467.47	$781.94	$979.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $389.45 / $816.48 / $3,703.71	Facility		$389.45	$816.48	$3,703.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $367.77 / $524.95 / $889.04	Professional		$367.77	$524.95	$889.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $525.13	Professional		$50.00	$70.00	$525.13
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $224.98 / $617.82 / $938.95	Facility		$224.98	$617.82	$938.95
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $467.47 / $781.94 / $979.78	Professional		$467.47	$781.94	$979.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $816.48 / $1,256.51 / $2,090.71	Professional		$816.48	$1,256.51	$2,090.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $555.76 / $1,594.68 / $3,703.71	Facility		$555.76	$1,594.68	$3,703.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $405.70 / $555.76 / $4,638.32	Professional		$405.70	$555.76	$4,638.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $816.48 / $816.48 / $816.48	Professional		$816.48	$816.48	$816.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $816.48 / $816.48 / $816.48	Professional		$816.48	$816.48	$816.48
United Facility/Professional Professional Modifier Low / Median / High Price $290.41 / $464.66 / $700.24	Professional		$290.41	$464.66	$700.24