Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.63 / $346.63 / $346.63	Facility		$346.63	$346.63	$346.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.52 / $346.63 / $575.54	Professional		$239.52	$346.63	$575.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $687.12 / $755.83 / $1,250.56	Facility		$687.12	$755.83	$1,250.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $594.28 / $639.02 / $845.15	Professional		$594.28	$639.02	$845.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $494.32 / $1,470.44 / $1,470.44	Facility		$494.32	$1,470.44	$1,470.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $444.49 / $1,420.25 / $2,867.71	Facility		$444.49	$1,420.25	$2,867.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $324.48 / $995.63 / $1,300.44	Professional		$324.48	$995.63	$1,300.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $185.18 / $519.95 / $790.19	Facility		$185.18	$519.95	$790.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $393.42 / $574.98 / $824.54	Professional		$393.42	$574.98	$824.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $320.56 / $687.12 / $2,994.68	Facility		$320.56	$687.12	$2,994.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $309.51 / $432.10 / $748.20	Professional		$309.51	$432.10	$748.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $296.52	Professional		$50.00	$70.00	$296.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $185.18 / $519.95 / $790.19	Facility		$185.18	$519.95	$790.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $393.42 / $574.98 / $824.54	Professional		$393.42	$574.98	$824.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $687.12 / $1,057.46 / $1,721.35	Professional		$687.12	$1,057.46	$1,721.35
Quartz Facility/Professional Facility Modifier Low / Median / High Price $444.49 / $1,342.04 / $2,994.68	Facility		$444.49	$1,342.04	$2,994.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $324.48 / $444.49 / $3,817.82	Professional		$324.48	$444.49	$3,817.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $687.12 / $687.12 / $687.12	Professional		$687.12	$687.12	$687.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $687.12 / $687.12 / $687.12	Professional		$687.12	$687.12	$687.12
United Facility/Professional Facility Modifier Low / Median / High Price $108.00 / $108.00 / $108.00	Facility		$108.00	$108.00	$108.00
United Facility/Professional Professional Modifier Low / Median / High Price $239.04 / $431.66 / $609.22	Professional		$239.04	$431.66	$609.22