Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $409.43 / $409.43 / $409.43	Facility		$409.43	$409.43	$409.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.93 / $409.43 / $685.95	Professional		$339.93	$409.43	$685.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $811.62 / $892.78 / $1,477.15	Facility		$811.62	$892.78	$1,477.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $701.97 / $754.81 / $998.29	Professional		$701.97	$754.81	$998.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $583.88 / $1,736.87 / $1,736.87	Facility		$583.88	$1,736.87	$1,736.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $525.23 / $1,792.29 / $3,388.34	Facility		$525.23	$1,792.29	$3,388.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $383.42 / $1,194.91 / $1,536.06	Professional		$383.42	$1,194.91	$1,536.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $245.20 / $649.29 / $933.36	Facility		$245.20	$649.29	$933.36
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $792.18 / $811.62 / $973.94	Professional		$792.18	$811.62	$973.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $409.43 / $811.62 / $3,779.52	Facility		$409.43	$811.62	$3,779.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $372.55 / $544.33 / $888.43	Professional		$372.55	$544.33	$888.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $282.00	Professional		$50.00	$70.00	$282.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $245.20 / $649.29 / $933.36	Facility		$245.20	$649.29	$933.36
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $792.18 / $811.62 / $973.94	Professional		$792.18	$811.62	$973.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $811.62 / $1,249.03 / $2,170.00	Professional		$811.62	$1,249.03	$2,170.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $525.23 / $1,585.20 / $3,779.52	Facility		$525.23	$1,585.20	$3,779.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $383.42 / $525.23 / $4,086.44	Professional		$383.42	$525.23	$4,086.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $811.62 / $811.62 / $811.62	Professional		$811.62	$811.62	$811.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $811.62 / $811.62 / $811.62	Professional		$811.62	$811.62	$811.62
United Facility/Professional Professional Modifier Low / Median / High Price $323.33 / $477.98 / $719.59	Professional		$323.33	$477.98	$719.59