Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $493.72 / $493.72 / $493.72	Facility		$493.72	$493.72	$493.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $382.72 / $493.72 / $819.76	Professional		$382.72	$493.72	$819.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $978.71 / $1,076.58 / $1,781.25	Facility		$978.71	$1,076.58	$1,781.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $846.48 / $910.20 / $1,203.81	Professional		$846.48	$910.20	$1,203.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $704.08 / $2,094.44 / $2,094.44	Facility		$704.08	$2,094.44	$2,094.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.36 / $2,023.46 / $4,085.33	Facility		$644.36	$2,023.46	$4,085.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $470.38 / $1,418.44 / $1,852.29	Professional		$470.38	$1,418.44	$1,852.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $242.00 / $740.58 / $1,125.52	Facility		$242.00	$740.58	$1,125.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $560.39 / $969.07 / $1,174.45	Professional		$560.39	$969.07	$1,174.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $418.91 / $978.71 / $4,034.25	Facility		$418.91	$978.71	$4,034.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $440.86 / $564.79 / $1,065.69	Professional		$440.86	$564.79	$1,065.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $553.58	Professional		$50.00	$70.00	$553.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $242.00 / $740.58 / $1,125.52	Facility		$242.00	$740.58	$1,125.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $560.39 / $969.07 / $1,174.45	Professional		$560.39	$969.07	$1,174.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $978.71 / $1,468.07 / $2,249.29	Professional		$978.71	$1,468.07	$2,249.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $644.36 / $1,911.54 / $4,034.25	Facility		$644.36	$1,911.54	$4,034.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $470.38 / $644.36 / $4,651.54	Professional		$470.38	$644.36	$4,651.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $978.71 / $978.71 / $978.71	Professional		$978.71	$978.71	$978.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $978.71 / $978.71 / $978.71	Professional		$978.71	$978.71	$978.71
United Facility/Professional Professional Modifier Low / Median / High Price $374.86 / $499.81 / $839.39	Professional		$374.86	$499.81	$839.39