Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $307.35 / $307.35 / $307.35	Facility		$307.35	$307.35	$307.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.18 / $307.35 / $514.92	Professional		$255.18	$307.35	$514.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $609.27 / $670.20 / $1,108.86	Facility		$609.27	$670.20	$1,108.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $526.95 / $566.62 / $749.40	Professional		$526.95	$566.62	$749.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $438.31 / $1,303.83 / $1,303.83	Facility		$438.31	$1,303.83	$1,303.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $401.27 / $1,345.45 / $2,543.01	Facility		$401.27	$1,345.45	$2,543.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.93 / $883.13 / $1,153.08	Professional		$292.93	$883.13	$1,153.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $175.30 / $461.03 / $700.66	Facility		$175.30	$461.03	$700.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $348.86 / $594.66 / $731.12	Professional		$348.86	$594.66	$731.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $303.45 / $609.27 / $2,837.20	Facility		$303.45	$609.27	$2,837.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $278.20 / $407.11 / $663.42	Professional		$278.20	$407.11	$663.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $411.18	Professional		$50.00	$70.00	$411.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $175.30 / $461.03 / $700.66	Facility		$175.30	$461.03	$700.66
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $348.86 / $594.66 / $731.12	Professional		$348.86	$594.66	$731.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $609.27 / $937.63 / $1,629.01	Professional		$609.27	$937.63	$1,629.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $401.27 / $1,189.98 / $2,837.20	Facility		$401.27	$1,189.98	$2,837.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $292.93 / $401.27 / $3,067.43	Professional		$292.93	$401.27	$3,067.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $609.27 / $609.27 / $609.27	Professional		$609.27	$609.27	$609.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $609.27 / $609.27 / $609.27	Professional		$609.27	$609.27	$609.27
United Facility/Professional Professional Modifier Low / Median / High Price $242.73 / $389.56 / $609.27	Professional		$242.73	$389.56	$609.27