Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.87 / $398.87 / $398.87	Facility		$398.87	$398.87	$398.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $296.25 / $398.87 / $662.27	Professional		$296.25	$398.87	$662.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $790.68 / $869.75 / $1,439.04	Facility		$790.68	$869.75	$1,439.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $672.07 / $735.33 / $972.53	Professional		$672.07	$735.33	$972.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $568.82 / $1,692.06 / $1,692.06	Facility		$568.82	$1,692.06	$1,692.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $440.05 / $1,746.21 / $3,300.17	Facility		$440.05	$1,746.21	$3,300.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.24 / $1,145.63 / $1,496.43	Professional		$321.24	$1,145.63	$1,496.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $215.25 / $598.30 / $909.28	Facility		$215.25	$598.30	$909.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $452.72 / $783.72 / $948.82	Professional		$452.72	$783.72	$948.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $372.61 / $790.68 / $3,490.95	Facility		$372.61	$790.68	$3,490.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $356.17 / $502.25 / $860.95	Professional		$356.17	$502.25	$860.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $533.58	Professional		$50.00	$70.00	$533.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $215.25 / $598.30 / $909.28	Facility		$215.25	$598.30	$909.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $452.72 / $783.72 / $948.82	Professional		$452.72	$783.72	$948.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $790.68 / $1,216.83 / $2,000.37	Professional		$790.68	$1,216.83	$2,000.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $440.05 / $1,544.30 / $3,490.95	Facility		$440.05	$1,544.30	$3,490.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $321.24 / $440.05 / $3,773.79	Professional		$321.24	$440.05	$3,773.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $790.68 / $790.68 / $790.68	Professional		$790.68	$790.68	$790.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $790.68 / $790.68 / $790.68	Professional		$790.68	$790.68	$790.68
United Facility/Professional Professional Modifier Low / Median / High Price $315.00 / $474.41 / $790.68	Professional		$315.00	$474.41	$790.68