Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $313.55 / $313.55 / $313.55	Facility		$313.55	$313.55	$313.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.81 / $313.55 / $520.62	Professional		$219.81	$313.55	$520.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $621.55 / $683.72 / $1,131.24	Facility		$621.55	$683.72	$1,131.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.58 / $578.04 / $764.51	Professional		$537.58	$578.04	$764.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $447.15 / $1,330.14 / $1,330.14	Facility		$447.15	$1,330.14	$1,330.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $402.09 / $1,285.17 / $2,594.79	Facility		$402.09	$1,285.17	$2,594.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.52 / $900.94 / $1,176.34	Professional		$293.52	$900.94	$1,176.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $169.94 / $470.33 / $714.79	Facility		$169.94	$470.33	$714.79
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $355.90 / $621.55 / $745.87	Professional		$355.90	$621.55	$745.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $294.18 / $621.55 / $2,775.01	Facility		$294.18	$621.55	$2,775.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $279.98 / $396.54 / $676.80	Professional		$279.98	$396.54	$676.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $419.46	Professional		$50.00	$70.00	$419.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $169.94 / $470.33 / $714.79	Facility		$169.94	$470.33	$714.79
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $355.90 / $621.55 / $745.87	Professional		$355.90	$621.55	$745.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $621.55 / $956.55 / $1,579.82	Professional		$621.55	$956.55	$1,579.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $402.09 / $1,213.98 / $2,775.01	Facility		$402.09	$1,213.98	$2,775.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $293.52 / $402.09 / $3,149.47	Professional		$293.52	$402.09	$3,149.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $621.55 / $621.55 / $621.55	Professional		$621.55	$621.55	$621.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $621.55 / $621.55 / $621.55	Professional		$621.55	$621.55	$621.55
United Facility/Professional Facility Modifier Low / Median / High Price $260.00 / $260.00 / $260.00	Facility		$260.00	$260.00	$260.00
United Facility/Professional Professional Modifier Low / Median / High Price $219.37 / $372.94 / $621.55	Professional		$219.37	$372.94	$621.55