Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $411.16 / $411.16 / $411.16	Facility		$411.16	$411.16	$411.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.81 / $411.16 / $682.69	Professional		$292.81	$411.16	$682.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $815.05 / $896.56 / $1,483.39	Facility		$815.05	$896.56	$1,483.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $704.94 / $758.00 / $1,002.51	Professional		$704.94	$758.00	$1,002.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $586.35 / $1,744.21 / $1,744.21	Facility		$586.35	$1,744.21	$1,744.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $527.25 / $1,799.28 / $3,402.34	Facility		$527.25	$1,799.28	$3,402.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $384.89 / $1,200.15 / $1,542.55	Professional		$384.89	$1,200.15	$1,542.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $226.39 / $616.74 / $937.31	Facility		$226.39	$616.74	$937.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $466.68 / $815.05 / $978.06	Professional		$466.68	$815.05	$978.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $391.89 / $815.05 / $3,676.89	Facility		$391.89	$815.05	$3,676.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $371.46 / $528.24 / $887.49	Professional		$371.46	$528.24	$887.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $519.54	Professional		$50.00	$70.00	$519.54
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $226.39 / $616.74 / $937.31	Facility		$226.39	$616.74	$937.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $466.68 / $815.05 / $978.06	Professional		$466.68	$815.05	$978.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $815.05 / $1,254.34 / $2,103.76	Professional		$815.05	$1,254.34	$2,103.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $527.25 / $1,591.90 / $3,676.89	Facility		$527.25	$1,591.90	$3,676.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $384.89 / $527.25 / $4,607.85	Professional		$384.89	$527.25	$4,607.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $815.05 / $815.05 / $815.05	Professional		$815.05	$815.05	$815.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $815.05 / $815.05 / $815.05	Professional		$815.05	$815.05	$815.05
United Facility/Professional Professional Modifier Low / Median / High Price $324.70 / $503.09 / $815.05	Professional		$324.70	$503.09	$815.05