Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $417.57 / $417.57 / $417.57	Facility		$417.57	$417.57	$417.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.57 / $417.57 / $794.19	Professional		$393.57	$417.57	$794.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $827.74 / $910.51 / $1,506.49	Facility		$827.74	$910.51	$1,506.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $744.96 / $769.80 / $1,018.12	Professional		$744.96	$769.80	$1,018.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $595.47 / $1,771.36 / $1,771.36	Facility		$595.47	$1,771.36	$1,771.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $511.94 / $1,711.06 / $3,455.52	Facility		$511.94	$1,711.06	$3,455.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.72 / $1,378.58 / $1,566.56	Professional		$373.72	$1,378.58	$1,566.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $228.22 / $626.36 / $951.90	Facility		$228.22	$626.36	$951.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $473.95 / $827.74 / $993.29	Professional		$473.95	$827.74	$993.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $395.05 / $827.74 / $3,937.24	Facility		$395.05	$827.74	$3,937.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $358.25 / $532.50 / $901.31	Professional		$358.25	$532.50	$901.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $207.76	Professional		$50.00	$70.00	$207.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $228.22 / $626.36 / $951.90	Facility		$228.22	$626.36	$951.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $473.95 / $827.74 / $993.29	Professional		$473.95	$827.74	$993.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $827.74 / $1,273.83 / $2,120.82	Professional		$827.74	$1,273.83	$2,120.82
Quartz Facility/Professional Facility Modifier Low / Median / High Price $511.94 / $1,616.68 / $3,937.24	Facility		$511.94	$1,616.68	$3,937.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $373.72 / $511.94 / $4,534.89	Professional		$373.72	$511.94	$4,534.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $827.74 / $827.74 / $827.74	Professional		$827.74	$827.74	$827.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $827.74 / $827.74 / $827.74	Professional		$827.74	$827.74	$827.74
United Facility/Professional Professional Modifier Low / Median / High Price $294.58 / $507.15 / $801.39	Professional		$294.58	$507.15	$801.39