Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $311.42 / $311.42 / $311.42	Facility		$311.42	$311.42	$311.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.24 / $311.42 / $517.08	Professional		$199.24	$311.42	$517.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $617.34 / $679.07 / $1,123.56	Facility		$617.34	$679.07	$1,123.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $555.60 / $574.13 / $759.32	Professional		$555.60	$574.13	$759.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $444.11 / $1,321.11 / $1,321.11	Facility		$444.11	$1,321.11	$1,321.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $298.85 / $1,276.73 / $2,576.60	Facility		$298.85	$1,276.73	$2,576.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.16 / $894.38 / $1,168.35	Professional		$218.16	$894.38	$1,168.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $154.04 / $467.13 / $709.94	Facility		$154.04	$467.13	$709.94
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $353.46 / $570.10 / $740.81	Professional		$353.46	$570.10	$740.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $266.64 / $617.34 / $2,706.40	Facility		$266.64	$617.34	$2,706.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $275.76 / $359.50 / $672.20	Professional		$275.76	$359.50	$672.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $343.92	Professional		$50.00	$70.00	$343.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $154.04 / $467.13 / $709.94	Facility		$154.04	$467.13	$709.94
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $353.46 / $570.10 / $740.81	Professional		$353.46	$570.10	$740.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $617.34 / $926.01 / $1,431.28	Professional		$617.34	$926.01	$1,431.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $298.85 / $1,205.74 / $2,706.40	Facility		$298.85	$1,205.74	$2,706.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $218.16 / $298.85 / $3,134.29	Professional		$218.16	$298.85	$3,134.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $617.34 / $617.34 / $617.34	Professional		$617.34	$617.34	$617.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $617.34 / $617.34 / $617.34	Professional		$617.34	$617.34	$617.34
United Facility/Professional Professional Modifier Low / Median / High Price $215.65 / $359.06 / $617.34	Professional		$215.65	$359.06	$617.34