Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $265.47 / $265.47 / $265.47	Facility		$265.47	$265.47	$265.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.92 / $265.47 / $453.86	Professional		$224.92	$265.47	$453.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $526.23 / $578.85 / $957.74	Facility		$526.23	$578.85	$957.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $473.60 / $489.39 / $647.26	Professional		$473.60	$489.39	$647.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $378.57 / $1,126.13 / $1,126.13	Facility		$378.57	$1,126.13	$1,126.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $340.42 / $1,088.18 / $2,195.92	Facility		$340.42	$1,088.18	$2,195.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $248.51 / $762.66 / $995.94	Professional		$248.51	$762.66	$995.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $161.69 / $398.21 / $605.16	Facility		$161.69	$398.21	$605.16
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $301.31 / $526.23 / $631.48	Professional		$301.31	$526.23	$631.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $265.47 / $526.23 / $2,588.55	Facility		$265.47	$526.23	$2,588.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $244.67 / $351.62 / $594.12	Professional		$244.67	$351.62	$594.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $338.79	Professional		$50.00	$70.00	$338.79
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $161.69 / $398.21 / $605.16	Facility		$161.69	$398.21	$605.16
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $301.31 / $526.23 / $631.48	Professional		$301.31	$526.23	$631.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $526.23 / $809.86 / $1,502.54	Professional		$526.23	$809.86	$1,502.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $340.42 / $1,027.80 / $2,588.55	Facility		$340.42	$1,027.80	$2,588.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $248.51 / $340.42 / $3,033.72	Professional		$248.51	$340.42	$3,033.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $526.23 / $526.23 / $526.23	Professional		$526.23	$526.23	$526.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $526.23 / $526.23 / $526.23	Professional		$526.23	$526.23	$526.23
United Facility/Professional Professional Modifier Low / Median / High Price $209.65 / $333.94 / $526.23	Professional		$209.65	$333.94	$526.23