Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $472.35 / $472.35 / $472.35	Facility		$472.35	$472.35	$472.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.83 / $472.35 / $784.28	Professional		$316.83	$472.35	$784.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $936.35 / $1,029.99 / $1,704.16	Facility		$936.35	$1,029.99	$1,704.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.81 / $870.81 / $1,151.71	Professional		$870.81	$870.81	$1,151.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $673.60 / $2,003.79 / $2,003.79	Facility		$673.60	$2,003.79	$2,003.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $663.31 / $1,936.18 / $3,908.98	Facility		$663.31	$1,936.18	$3,908.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $484.22 / $1,357.03 / $1,772.11	Professional		$484.22	$1,357.03	$1,772.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $244.96 / $708.53 / $1,076.80	Facility		$244.96	$708.53	$1,076.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $536.12 / $936.35 / $1,123.61	Professional		$536.12	$936.35	$1,123.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $424.04 / $936.35 / $4,017.59	Facility		$424.04	$936.35	$4,017.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $421.78 / $571.58 / $1,019.57	Professional		$421.78	$571.58	$1,019.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $560.76	Professional		$50.00	$70.00	$560.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $244.96 / $708.53 / $1,076.80	Facility		$244.96	$708.53	$1,076.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $536.12 / $936.35 / $1,123.61	Professional		$536.12	$936.35	$1,123.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $936.35 / $1,441.00 / $2,276.39	Professional		$936.35	$1,441.00	$2,276.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $663.31 / $1,828.80 / $4,017.59	Facility		$663.31	$1,828.80	$4,017.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $484.22 / $663.31 / $5,540.85	Professional		$484.22	$663.31	$5,540.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $936.35 / $936.35 / $936.35	Professional		$936.35	$936.35	$936.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $747.64 / $936.35 / $936.35	Professional		$747.64	$936.35	$936.35
United Facility/Professional Professional Modifier Low / Median / High Price $373.03 / $571.70 / $936.35	Professional		$373.03	$571.70	$936.35