Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $322.02 / $322.02 / $322.02	Facility		$322.02	$322.02	$322.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $303.83 / $322.02 / $613.11	Professional		$303.83	$322.02	$613.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $638.35 / $702.19 / $1,161.80	Facility		$638.35	$702.19	$1,161.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $574.51 / $593.66 / $785.17	Professional		$574.51	$593.66	$785.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $459.24 / $1,366.07 / $1,366.07	Facility		$459.24	$1,366.07	$1,366.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $412.94 / $1,319.89 / $2,664.77	Facility		$412.94	$1,319.89	$2,664.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $924.84 / $1,208.13	Professional		$301.45	$924.84	$1,208.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $205.60 / $483.03 / $734.10	Facility		$205.60	$483.03	$734.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $365.50 / $638.35 / $851.13	Professional		$365.50	$638.35	$851.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $322.02 / $638.35 / $3,399.27	Facility		$322.02	$638.35	$3,399.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $296.80 / $426.53 / $720.69	Professional		$296.80	$426.53	$720.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $205.60 / $492.69 / $734.10	Facility		$205.60	$492.69	$734.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $365.50 / $638.35 / $851.13	Professional		$365.50	$638.35	$851.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $638.35 / $982.39 / $1,911.04	Professional		$638.35	$982.39	$1,911.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $412.94 / $1,246.78 / $3,399.27	Facility		$412.94	$1,246.78	$3,399.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $412.94 / $4,786.20	Professional		$301.45	$412.94	$4,786.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $638.35 / $638.35 / $638.35	Professional		$638.35	$638.35	$638.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $638.35 / $638.35 / $638.35	Professional		$638.35	$638.35	$638.35
United Facility/Professional Professional Modifier Low / Median / High Price $265.39 / $424.62 / $547.48	Professional		$265.39	$424.62	$547.48