Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.65 / $478.65 / $478.65	Facility		$478.65	$478.65	$478.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.52 / $478.65 / $794.75	Professional		$355.52	$478.65	$794.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $948.84 / $1,043.72 / $1,726.89	Facility		$948.84	$1,043.72	$1,726.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $820.65 / $882.42 / $1,167.07	Professional		$820.65	$882.42	$1,167.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $682.59 / $2,030.52 / $2,030.52	Facility		$682.59	$2,030.52	$2,030.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.15 / $2,094.83 / $3,960.77	Facility		$501.15	$2,094.83	$3,960.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.84 / $1,374.84 / $1,795.75	Professional		$365.84	$1,374.84	$1,795.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $258.31 / $717.98 / $1,091.17	Facility		$258.31	$717.98	$1,091.17
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $543.26 / $940.48 / $1,138.60	Professional		$543.26	$940.48	$1,138.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $447.14 / $948.84 / $4,189.30	Facility		$447.14	$948.84	$4,189.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $427.39 / $602.72 / $1,033.17	Professional		$427.39	$602.72	$1,033.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $640.30	Professional		$50.00	$70.00	$640.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $258.31 / $717.98 / $1,091.17	Facility		$258.31	$717.98	$1,091.17
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $543.26 / $940.48 / $1,138.60	Professional		$543.26	$940.48	$1,138.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $948.84 / $1,460.22 / $2,400.85	Professional		$948.84	$1,460.22	$2,400.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $501.15 / $1,853.20 / $4,189.30	Facility		$501.15	$1,853.20	$4,189.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $365.84 / $501.15 / $4,528.81	Professional		$365.84	$501.15	$4,528.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $948.84 / $948.84 / $948.84	Professional		$948.84	$948.84	$948.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $948.84 / $948.84 / $948.84	Professional		$948.84	$948.84	$948.84
United Facility/Professional Professional Modifier Low / Median / High Price $315.58 / $533.50 / $841.26	Professional		$315.58	$533.50	$841.26