Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.47 / $365.47 / $365.47	Facility		$365.47	$365.47	$365.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $261.33 / $365.47 / $606.82	Professional		$261.33	$365.47	$606.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.48 / $796.93 / $1,318.55	Facility		$724.48	$796.93	$1,318.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $626.60 / $673.77 / $891.11	Professional		$626.60	$673.77	$891.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $521.20 / $1,550.39 / $1,550.39	Facility		$521.20	$1,550.39	$1,550.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $468.67 / $1,498.11 / $3,024.46	Facility		$468.67	$1,498.11	$3,024.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.13 / $1,066.80 / $1,371.14	Professional		$342.13	$1,066.80	$1,371.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $201.85 / $548.21 / $833.15	Facility		$201.85	$548.21	$833.15
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $414.82 / $724.48 / $869.38	Professional		$414.82	$724.48	$869.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $349.41 / $724.48 / $3,286.44	Facility		$349.41	$724.48	$3,286.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $326.35 / $470.98 / $788.87	Professional		$326.35	$470.98	$788.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $422.95	Professional		$50.00	$70.00	$422.95
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $201.85 / $548.21 / $833.15	Facility		$201.85	$548.21	$833.15
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $414.82 / $724.48 / $869.38	Professional		$414.82	$724.48	$869.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $724.48 / $1,114.98 / $1,875.92	Professional		$724.48	$1,114.98	$1,875.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $468.67 / $1,415.00 / $3,286.44	Facility		$468.67	$1,415.00	$3,286.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $342.13 / $468.67 / $4,010.98	Professional		$342.13	$468.67	$4,010.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $724.48 / $724.48 / $724.48	Professional		$724.48	$724.48	$724.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $724.48 / $724.48 / $724.48	Professional		$724.48	$724.48	$724.48
United Facility/Professional Facility Modifier Low / Median / High Price $383.20 / $383.20 / $383.20	Facility		$383.20	$383.20	$383.20
United Facility/Professional Professional Modifier Low / Median / High Price $260.55 / $434.69 / $642.33	Professional		$260.55	$434.69	$642.33