Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $378.66 / $378.66 / $378.66	Facility		$378.66	$378.66	$378.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.69 / $378.66 / $630.97	Professional		$312.69	$378.66	$630.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $750.62 / $825.68 / $1,366.13	Facility		$750.62	$825.68	$1,366.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $675.55 / $698.08 / $923.26	Professional		$675.55	$698.08	$923.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $539.99 / $1,606.33 / $1,606.33	Facility		$539.99	$1,606.33	$1,606.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $485.57 / $1,551.58 / $3,133.62	Facility		$485.57	$1,551.58	$3,133.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.47 / $1,087.97 / $1,420.59	Professional		$354.47	$1,087.97	$1,420.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $241.75 / $567.99 / $863.21	Facility		$241.75	$567.99	$863.21
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $429.78 / $750.62 / $1,000.82	Professional		$429.78	$750.62	$1,000.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $378.66 / $750.62 / $3,853.16	Facility		$378.66	$750.62	$3,853.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $349.00 / $501.55 / $847.44	Professional		$349.00	$501.55	$847.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $516.69	Professional		$50.00	$70.00	$516.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $241.75 / $579.35 / $863.21	Facility		$241.75	$579.35	$863.21
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $429.78 / $750.62 / $1,000.82	Professional		$429.78	$750.62	$1,000.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $750.62 / $1,155.17 / $2,247.28	Professional		$750.62	$1,155.17	$2,247.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $485.57 / $1,466.04 / $3,853.16	Facility		$485.57	$1,466.04	$3,853.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $354.47 / $485.57 / $5,024.43	Professional		$354.47	$485.57	$5,024.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $750.62 / $750.62 / $750.62	Professional		$750.62	$750.62	$750.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $750.62 / $750.62 / $750.62	Professional		$750.62	$750.62	$750.62
United Facility/Professional Professional Modifier Low / Median / High Price $299.04 / $450.37 / $750.62	Professional		$299.04	$450.37	$750.62