Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $434.49 / $434.49 / $434.49	Facility		$434.49	$434.49	$434.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.30 / $434.49 / $862.92	Professional		$426.30	$434.49	$862.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $861.30 / $947.43 / $1,567.57	Facility		$861.30	$947.43	$1,567.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $775.17 / $801.01 / $1,059.39	Professional		$775.17	$801.01	$1,059.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $619.62 / $1,843.18 / $1,843.18	Facility		$619.62	$1,843.18	$1,843.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $496.34 / $1,780.49 / $3,595.48	Facility		$496.34	$1,780.49	$3,595.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $362.33 / $1,434.47 / $1,630.08	Professional		$362.33	$1,434.47	$1,630.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $247.97 / $651.74 / $990.50	Facility		$247.97	$651.74	$990.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $493.17 / $769.91 / $1,033.56	Professional		$493.17	$769.91	$1,033.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $429.24 / $861.30 / $3,942.99	Facility		$429.24	$861.30	$3,942.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $400.47 / $575.50 / $937.85	Professional		$400.47	$575.50	$937.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $231.97	Professional		$50.00	$70.00	$231.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $247.97 / $651.74 / $990.50	Facility		$247.97	$651.74	$990.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $493.17 / $769.91 / $1,033.56	Professional		$493.17	$769.91	$1,033.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $861.30 / $1,325.51 / $2,304.50	Professional		$861.30	$1,325.51	$2,304.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $496.34 / $1,682.22 / $3,942.99	Facility		$496.34	$1,682.22	$3,942.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $362.33 / $496.34 / $4,278.29	Professional		$362.33	$496.34	$4,278.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $861.30 / $861.30 / $861.30	Professional		$861.30	$861.30	$861.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $861.30 / $861.30 / $861.30	Professional		$861.30	$861.30	$861.30
United Facility/Professional Professional Modifier Low / Median / High Price $320.08 / $512.14 / $861.30	Professional		$320.08	$512.14	$861.30