Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.24 / $349.24 / $349.24	Facility		$349.24	$349.24	$349.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.39 / $349.24 / $581.96	Professional		$288.39	$349.24	$581.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $692.31 / $761.54 / $1,260.00	Facility		$692.31	$761.54	$1,260.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $623.07 / $643.85 / $851.54	Professional		$623.07	$643.85	$851.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $498.06 / $1,481.54 / $1,481.54	Facility		$498.06	$1,481.54	$1,481.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $432.60 / $1,431.54 / $2,890.10	Facility		$432.60	$1,431.54	$2,890.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.80 / $1,003.13 / $1,310.26	Professional		$315.80	$1,003.13	$1,310.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $222.98 / $523.86 / $796.16	Facility		$222.98	$523.86	$796.16
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $396.40 / $692.31 / $830.77	Professional		$396.40	$692.31	$830.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $349.24 / $689.15 / $3,605.80	Facility		$349.24	$689.15	$3,605.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $321.89 / $462.58 / $761.54	Professional		$321.89	$462.58	$761.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $249.11	Professional		$50.00	$70.00	$249.11
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $222.98 / $523.86 / $796.16	Facility		$222.98	$523.86	$796.16
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $396.40 / $692.31 / $830.77	Professional		$396.40	$692.31	$830.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $692.31 / $1,065.44 / $2,072.64	Professional		$692.31	$1,065.44	$2,072.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $432.60 / $1,352.18 / $3,605.80	Facility		$432.60	$1,352.18	$3,605.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $315.80 / $432.60 / $4,596.99	Professional		$315.80	$432.60	$4,596.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $692.31 / $692.31 / $692.31	Professional		$692.31	$692.31	$692.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $692.31 / $692.31 / $692.31	Professional		$692.31	$692.31	$692.31
United Facility/Professional Facility Modifier Low / Median / High Price $0.55 / $519.76 / $520.39	Facility		$0.55	$519.76	$520.39
United Facility/Professional Professional Modifier Low / Median / High Price $300.68 / $460.52 / $613.80	Professional		$300.68	$460.52	$613.80