Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $471.06 / $471.06 / $471.06	Facility		$471.06	$471.06	$471.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.14 / $471.06 / $791.31	Professional		$392.14	$471.06	$791.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $933.80 / $1,027.18 / $1,699.52	Facility		$933.80	$1,027.18	$1,699.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $840.42 / $868.43 / $1,148.57	Professional		$840.42	$868.43	$1,148.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $671.78 / $1,998.33 / $1,998.33	Facility		$671.78	$1,998.33	$1,998.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $583.49 / $1,930.58 / $3,897.79	Facility		$583.49	$1,930.58	$3,897.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.95 / $1,353.28 / $1,767.29	Professional		$425.95	$1,353.28	$1,767.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $300.75 / $706.59 / $1,073.86	Facility		$300.75	$706.59	$1,073.86
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $534.66 / $933.80 / $1,120.56	Professional		$534.66	$933.80	$1,120.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $471.06 / $933.80 / $4,826.53	Facility		$471.06	$933.80	$4,826.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $434.17 / $623.94 / $1,054.25	Professional		$434.17	$623.94	$1,054.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $630.17	Professional		$50.00	$70.00	$630.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $300.75 / $720.72 / $1,073.86	Facility		$300.75	$720.72	$1,073.86
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $534.66 / $933.80 / $1,120.56	Professional		$534.66	$933.80	$1,120.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $933.80 / $1,437.10 / $2,795.30	Professional		$933.80	$1,437.10	$2,795.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $583.49 / $1,823.82 / $4,826.53	Facility		$583.49	$1,823.82	$4,826.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $425.95 / $583.49 / $6,163.10	Professional		$425.95	$583.49	$6,163.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $933.80 / $933.80 / $933.80	Professional		$933.80	$933.80	$933.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $745.62 / $933.80 / $933.80	Professional		$745.62	$933.80	$933.80
United Facility/Professional Facility Modifier Low / Median / High Price $466.72 / $466.72 / $466.72	Facility		$466.72	$466.72	$466.72
United Facility/Professional Professional Modifier Low / Median / High Price $372.02 / $621.15 / $933.80	Professional		$372.02	$621.15	$933.80