Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $336.03 / $336.03 / $336.03	Facility		$336.03	$336.03	$336.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.52 / $336.03 / $557.92	Professional		$246.52	$336.03	$557.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $666.10 / $732.71 / $1,212.30	Facility		$666.10	$732.71	$1,212.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $576.10 / $619.47 / $819.30	Professional		$576.10	$619.47	$819.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $479.20 / $1,425.45 / $1,425.45	Facility		$479.20	$1,425.45	$1,425.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.78 / $1,377.11 / $2,780.93	Facility		$400.78	$1,377.11	$2,780.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.57 / $965.16 / $1,260.65	Professional		$292.57	$965.16	$1,260.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $190.60 / $504.05 / $766.02	Facility		$190.60	$504.05	$766.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $381.40 / $666.10 / $799.32	Professional		$381.40	$666.10	$799.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $329.94 / $666.10 / $3,128.35	Facility		$329.94	$666.10	$3,128.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $300.05 / $444.29 / $738.09	Professional		$300.05	$444.29	$738.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $399.37	Professional		$50.00	$70.00	$399.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $190.60 / $504.05 / $766.02	Facility		$190.60	$504.05	$766.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $381.40 / $666.10 / $799.32	Professional		$381.40	$666.10	$799.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $666.10 / $1,025.13 / $1,771.53	Professional		$666.10	$1,025.13	$1,771.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $400.78 / $1,300.98 / $3,128.35	Facility		$400.78	$1,300.98	$3,128.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $292.57 / $400.78 / $4,372.97	Professional		$292.57	$400.78	$4,372.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $666.10 / $666.10 / $666.10	Professional		$666.10	$666.10	$666.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $666.10 / $666.10 / $666.10	Professional		$666.10	$666.10	$666.10
United Facility/Professional Professional Modifier Low / Median / High Price $265.37 / $443.09 / $666.10	Professional		$265.37	$443.09	$666.10