Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $321.26 / $321.26 / $321.26	Facility		$321.26	$321.26	$321.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $265.29 / $321.26 / $535.33	Professional		$265.29	$321.26	$535.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $636.84 / $700.52 / $1,159.05	Facility		$636.84	$700.52	$1,159.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $573.15 / $592.26 / $783.31	Professional		$573.15	$592.26	$783.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $458.14 / $1,362.84 / $1,362.84	Facility		$458.14	$1,362.84	$1,362.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $397.94 / $1,317.07 / $2,657.77	Facility		$397.94	$1,317.07	$2,657.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.50 / $922.97 / $1,205.28	Professional		$290.50	$922.97	$1,205.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $205.11 / $481.89 / $732.37	Facility		$205.11	$481.89	$732.37
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $364.63 / $636.84 / $764.21	Professional		$364.63	$636.84	$764.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $321.26 / $636.84 / $3,385.23	Facility		$321.26	$636.84	$3,385.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $296.10 / $425.51 / $700.52	Professional		$296.10	$425.51	$700.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $407.47	Professional		$50.00	$70.00	$407.47
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $205.11 / $491.53 / $732.37	Facility		$205.11	$491.53	$732.37
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $364.63 / $636.84 / $764.21	Professional		$364.63	$636.84	$764.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $636.84 / $980.07 / $1,906.03	Professional		$636.84	$980.07	$1,906.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $397.94 / $1,243.83 / $3,385.23	Facility		$397.94	$1,243.83	$3,385.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $290.50 / $397.94 / $4,203.14	Professional		$290.50	$397.94	$4,203.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $636.84 / $636.84 / $636.84	Professional		$636.84	$636.84	$636.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $508.50 / $636.84 / $636.84	Professional		$508.50	$636.84	$636.84
United Facility/Professional Professional Modifier Low / Median / High Price $264.76 / $423.62 / $636.84	Professional		$264.76	$423.62	$636.84