Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.22 / $316.22 / $316.22	Facility		$316.22	$316.22	$316.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $262.54 / $316.22 / $529.78	Professional		$262.54	$316.22	$529.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $626.85 / $689.54 / $1,140.86	Facility		$626.85	$689.54	$1,140.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $564.16 / $582.97 / $771.02	Professional		$564.16	$582.97	$771.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $450.95 / $1,341.46 / $1,341.46	Facility		$450.95	$1,341.46	$1,341.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $405.51 / $1,384.55 / $2,617.17	Facility		$405.51	$1,384.55	$2,617.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.02 / $908.44 / $1,186.35	Professional		$296.02	$908.44	$1,186.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $180.36 / $474.33 / $720.88	Facility		$180.36	$474.33	$720.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $358.93 / $611.79 / $752.22	Professional		$358.93	$611.79	$752.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $312.20 / $626.85 / $2,919.01	Facility		$312.20	$626.85	$2,919.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $286.23 / $418.85 / $682.57	Professional		$286.23	$418.85	$682.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $423.04	Professional		$50.00	$70.00	$423.04
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $180.36 / $474.33 / $720.88	Facility		$180.36	$474.33	$720.88
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $358.93 / $611.79 / $752.22	Professional		$358.93	$611.79	$752.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $626.85 / $964.73 / $1,676.18	Professional		$626.85	$964.73	$1,676.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $405.51 / $1,224.32 / $2,919.01	Facility		$405.51	$1,224.32	$2,919.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $296.02 / $405.51 / $3,156.12	Professional		$296.02	$405.51	$3,156.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $626.85 / $626.85 / $626.85	Professional		$626.85	$626.85	$626.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $626.85 / $626.85 / $626.85	Professional		$626.85	$626.85	$626.85
United Facility/Professional Professional Modifier Low / Median / High Price $232.80 / $372.48 / $626.85	Professional		$232.80	$372.48	$626.85