Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.29 / $428.29 / $428.29	Facility		$428.29	$428.29	$428.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $268.38 / $428.29 / $711.12	Professional		$268.38	$428.29	$711.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $849.00 / $933.90 / $1,545.18	Facility		$849.00	$933.90	$1,545.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $789.57 / $789.57 / $1,044.27	Professional		$789.57	$789.57	$1,044.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $610.77 / $1,816.86 / $1,816.86	Facility		$610.77	$1,816.86	$1,816.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $402.56 / $1,755.14 / $3,543.70	Facility		$402.56	$1,755.14	$3,543.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.87 / $1,230.47 / $1,606.80	Professional		$293.87	$1,230.47	$1,606.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $207.50 / $642.44 / $976.35	Facility		$207.50	$642.44	$976.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $486.12 / $736.58 / $1,018.80	Professional		$486.12	$736.58	$1,018.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $359.18 / $849.00 / $3,601.96	Facility		$359.18	$849.00	$3,601.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $353.21 / $484.26 / $924.45	Professional		$353.21	$484.26	$924.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $428.63	Professional		$50.00	$70.00	$428.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $207.50 / $642.44 / $976.35	Facility		$207.50	$642.44	$976.35
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $486.12 / $736.58 / $1,018.80	Professional		$486.12	$736.58	$1,018.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $849.00 / $1,273.50 / $1,928.11	Professional		$849.00	$1,273.50	$1,928.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $402.56 / $1,658.20 / $3,601.96	Facility		$402.56	$1,658.20	$3,601.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $293.87 / $402.56 / $4,252.00	Professional		$293.87	$402.56	$4,252.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $849.00 / $849.00 / $849.00	Professional		$849.00	$849.00	$849.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $849.00 / $849.00 / $849.00	Professional		$849.00	$849.00	$849.00
United Facility/Professional Professional Modifier Low / Median / High Price $290.49 / $428.54 / $728.15	Professional		$290.49	$428.54	$728.15