Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.87 / $380.87 / $380.87	Facility		$380.87	$380.87	$380.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $268.00 / $380.87 / $632.39	Professional		$268.00	$380.87	$632.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $755.01 / $830.51 / $1,374.12	Facility		$755.01	$830.51	$1,374.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $679.50 / $702.16 / $928.66	Professional		$679.50	$702.16	$928.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $543.15 / $1,615.72 / $1,615.72	Facility		$543.15	$1,615.72	$1,615.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $394.91 / $1,560.94 / $3,151.82	Facility		$394.91	$1,560.94	$3,151.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.27 / $1,094.06 / $1,428.91	Professional		$288.27	$1,094.06	$1,428.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $203.55 / $571.30 / $868.26	Facility		$203.55	$571.30	$868.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $432.30 / $731.90 / $906.01	Professional		$432.30	$731.90	$906.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $352.34 / $755.01 / $3,305.62	Facility		$352.34	$755.01	$3,305.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $340.10 / $474.94 / $822.11	Professional		$340.10	$474.94	$822.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $440.46	Professional		$50.00	$70.00	$440.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $203.55 / $571.30 / $868.26	Facility		$203.55	$571.30	$868.26
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $432.30 / $731.90 / $906.01	Professional		$432.30	$731.90	$906.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $755.01 / $1,161.92 / $1,891.97	Professional		$755.01	$1,161.92	$1,891.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $394.91 / $1,474.62 / $3,305.62	Facility		$394.91	$1,474.62	$3,305.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $288.27 / $394.91 / $3,622.91	Professional		$288.27	$394.91	$3,622.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $755.01 / $755.01 / $755.01	Professional		$755.01	$755.01	$755.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $602.86 / $755.01 / $755.01	Professional		$602.86	$755.01	$755.01
United Facility/Professional Professional Modifier Low / Median / High Price $262.75 / $453.01 / $647.53	Professional		$262.75	$453.01	$647.53