Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $357.89 / $357.89 / $357.89	Facility		$357.89	$357.89	$357.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $280.01 / $357.89 / $594.23	Professional		$280.01	$357.89	$594.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $709.45 / $780.40 / $1,291.20	Facility		$709.45	$780.40	$1,291.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $638.50 / $659.79 / $872.62	Professional		$638.50	$659.79	$872.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $510.38 / $1,518.22 / $1,518.22	Facility		$510.38	$1,518.22	$1,518.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $420.01 / $1,467.15 / $2,961.48	Facility		$420.01	$1,467.15	$2,961.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $306.61 / $1,027.97 / $1,342.69	Professional		$306.61	$1,027.97	$1,342.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $216.49 / $536.84 / $815.87	Facility		$216.49	$536.84	$815.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $406.21 / $709.45 / $896.23	Professional		$406.21	$709.45	$896.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $357.89 / $709.45 / $3,565.60	Facility		$357.89	$709.45	$3,565.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $329.86 / $474.03 / $800.94	Professional		$329.86	$474.03	$800.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $478.77	Professional		$50.00	$70.00	$478.77
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $216.49 / $547.57 / $815.87	Facility		$216.49	$547.57	$815.87
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $406.21 / $709.45 / $896.23	Professional		$406.21	$709.45	$896.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $709.45 / $1,091.80 / $2,012.42	Professional		$709.45	$1,091.80	$2,012.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $420.01 / $1,385.64 / $3,565.60	Facility		$420.01	$1,385.64	$3,565.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $306.61 / $420.01 / $4,843.43	Professional		$306.61	$420.01	$4,843.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $709.45 / $709.45 / $709.45	Professional		$709.45	$709.45	$709.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $566.47 / $709.45 / $709.45	Professional		$566.47	$709.45	$709.45
United Facility/Professional Professional Modifier Low / Median / High Price $279.45 / $452.22 / $629.00	Professional		$279.45	$452.22	$629.00