Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $303.70 / $303.70 / $303.70	Facility		$303.70	$303.70	$303.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.80 / $303.70 / $506.09	Professional		$250.80	$303.70	$506.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.04 / $662.26 / $1,095.73	Facility		$602.04	$662.26	$1,095.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $559.91 / $559.91 / $740.52	Professional		$559.91	$559.91	$740.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $433.12 / $1,288.39 / $1,288.39	Facility		$433.12	$1,288.39	$1,288.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $382.03 / $1,244.83 / $2,513.62	Facility		$382.03	$1,244.83	$2,513.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.88 / $872.34 / $1,139.43	Professional		$278.88	$872.34	$1,139.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $193.91 / $455.57 / $692.36	Facility		$193.91	$455.57	$692.36
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $344.72 / $602.04 / $722.46	Professional		$344.72	$602.04	$722.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $303.70 / $597.36 / $3,201.26	Facility		$303.70	$597.36	$3,201.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $279.92 / $402.27 / $679.70	Professional		$279.92	$402.27	$679.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $344.93	Professional		$50.00	$70.00	$344.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $193.91 / $455.57 / $692.36	Facility		$193.91	$455.57	$692.36
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $344.72 / $602.04 / $722.46	Professional		$344.72	$602.04	$722.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $602.04 / $926.54 / $1,802.65	Professional		$602.04	$926.54	$1,802.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $382.03 / $1,175.88 / $3,201.26	Facility		$382.03	$1,175.88	$3,201.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $278.88 / $382.03 / $3,997.65	Professional		$278.88	$382.03	$3,997.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $602.04 / $602.04 / $602.04	Professional		$602.04	$602.04	$602.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $480.73 / $602.04 / $602.04	Professional		$480.73	$602.04	$602.04
United Facility/Professional Professional Modifier Low / Median / High Price $235.18 / $361.23 / $533.79	Professional		$235.18	$361.23	$533.79