Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.37 / $346.37 / $346.37	Facility		$346.37	$346.37	$346.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.43 / $346.37 / $575.10	Professional		$243.43	$346.37	$575.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $686.60 / $755.26 / $1,249.60	Facility		$686.60	$755.26	$1,249.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $638.54 / $638.54 / $844.51	Professional		$638.54	$638.54	$844.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $493.95 / $1,469.32 / $1,469.32	Facility		$493.95	$1,469.32	$1,469.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $483.85 / $1,419.32 / $2,866.31	Facility		$483.85	$1,419.32	$2,866.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.21 / $995.16 / $1,299.45	Professional		$353.21	$995.16	$1,299.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $188.20 / $519.55 / $789.59	Facility		$188.20	$519.55	$789.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $393.14 / $686.60 / $823.92	Professional		$393.14	$686.60	$823.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $325.79 / $686.60 / $3,115.48	Facility		$325.79	$686.60	$3,115.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $295.44 / $439.15 / $747.63	Professional		$295.44	$439.15	$747.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $394.35	Professional		$50.00	$70.00	$394.35
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $188.20 / $519.55 / $789.59	Facility		$188.20	$519.55	$789.59
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $393.14 / $686.60 / $823.92	Professional		$393.14	$686.60	$823.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $686.60 / $1,056.66 / $1,749.45	Professional		$686.60	$1,056.66	$1,749.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $483.85 / $1,341.02 / $3,115.48	Facility		$483.85	$1,341.02	$3,115.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $353.21 / $483.85 / $4,550.09	Professional		$353.21	$483.85	$4,550.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $686.60 / $686.60 / $686.60	Professional		$686.60	$686.60	$686.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $548.25 / $686.60 / $686.60	Professional		$548.25	$686.60	$686.60
United Facility/Professional Facility Modifier Low / Median / High Price $389.42 / $389.42 / $389.42	Facility		$389.42	$389.42	$389.42
United Facility/Professional Professional Modifier Low / Median / High Price $242.94 / $437.66 / $747.63	Professional		$242.94	$437.66	$747.63