Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $454.01 / $454.01 / $454.01	Facility		$454.01	$454.01	$454.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $359.50 / $454.01 / $753.83	Professional		$359.50	$454.01	$753.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $899.99 / $989.99 / $1,637.98	Facility		$899.99	$989.99	$1,637.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $809.99 / $836.99 / $1,106.98	Professional		$809.99	$836.99	$1,106.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $647.46 / $1,925.98 / $1,925.98	Facility		$647.46	$1,925.98	$1,925.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $582.20 / $1,861.16 / $3,756.43	Facility		$582.20	$1,861.16	$3,756.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.01 / $1,304.06 / $1,703.31	Professional		$425.01	$1,304.06	$1,703.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $277.95 / $681.02 / $1,034.99	Facility		$277.95	$681.02	$1,034.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $515.32 / $899.99 / $1,079.99	Professional		$515.32	$899.99	$1,079.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $454.01 / $899.99 / $4,473.42	Facility		$454.01	$899.99	$4,473.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $418.46 / $601.36 / $1,016.10	Professional		$418.46	$601.36	$1,016.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $582.40	Professional		$50.00	$70.00	$582.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $277.95 / $692.08 / $1,034.99	Facility		$277.95	$692.08	$1,034.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $515.32 / $899.99 / $1,079.99	Professional		$515.32	$899.99	$1,079.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $899.99 / $1,385.08 / $2,583.52	Professional		$899.99	$1,385.08	$2,583.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $582.20 / $1,757.80 / $4,473.42	Facility		$582.20	$1,757.80	$4,473.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $425.01 / $582.20 / $5,695.77	Professional		$425.01	$582.20	$5,695.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $899.99 / $899.99 / $899.99	Professional		$899.99	$899.99	$899.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $718.63 / $899.99 / $899.99	Professional		$718.63	$899.99	$899.99
United Facility/Professional Facility Modifier Low / Median / High Price $500.36 / $500.36 / $500.36	Facility		$500.36	$500.36	$500.36
United Facility/Professional Professional Modifier Low / Median / High Price $358.79 / $539.99 / $899.99	Professional		$358.79	$539.99	$899.99