Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $477.99 / $477.99 / $477.99	Facility		$477.99	$477.99	$477.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $364.65 / $477.99 / $793.64	Professional		$364.65	$477.99	$793.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $947.52 / $1,042.27 / $1,724.49	Facility		$947.52	$1,042.27	$1,724.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $852.76 / $881.19 / $1,165.44	Professional		$852.76	$881.19	$1,165.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $681.64 / $2,027.69 / $2,027.69	Facility		$681.64	$2,027.69	$2,027.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $612.94 / $1,958.70 / $3,955.17	Facility		$612.94	$1,958.70	$3,955.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $447.45 / $1,372.97 / $1,793.25	Professional		$447.45	$1,372.97	$1,793.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $281.93 / $716.99 / $1,089.65	Facility		$281.93	$716.99	$1,089.65
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $542.53 / $947.52 / $1,167.14	Professional		$542.53	$947.52	$1,167.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $477.99 / $947.52 / $4,719.35	Facility		$477.99	$947.52	$4,719.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $436.70 / $633.11 / $1,069.73	Professional		$436.70	$633.11	$1,069.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $590.74	Professional		$50.00	$70.00	$590.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $281.93 / $718.22 / $1,089.65	Facility		$281.93	$718.22	$1,089.65
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $542.53 / $947.52 / $1,167.14	Professional		$542.53	$947.52	$1,167.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $947.52 / $1,458.21 / $2,620.66	Professional		$947.52	$1,458.21	$2,620.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $612.94 / $1,850.62 / $4,719.35	Facility		$612.94	$1,850.62	$4,719.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $447.45 / $612.94 / $6,654.78	Professional		$447.45	$612.94	$6,654.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $947.52 / $947.52 / $947.52	Professional		$947.52	$947.52	$947.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $756.58 / $947.52 / $947.52	Professional		$756.58	$947.52	$947.52
United Facility/Professional Facility Modifier Low / Median / High Price $0.70 / $657.18 / $657.98	Facility		$0.70	$657.18	$657.98
United Facility/Professional Professional Modifier Low / Median / High Price $377.48 / $582.27 / $840.08	Professional		$377.48	$582.27	$840.08