Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $442.68 / $442.68 / $442.68	Facility		$442.68	$442.68	$442.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $367.54 / $442.68 / $741.67	Professional		$367.54	$442.68	$741.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $877.53 / $965.28 / $1,597.10	Facility		$877.53	$965.28	$1,597.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $806.97 / $816.10 / $1,079.35	Professional		$806.97	$816.10	$1,079.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $631.29 / $1,877.91 / $1,877.91	Facility		$631.29	$1,877.91	$1,877.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $624.54 / $1,937.56 / $3,662.66	Facility		$624.54	$1,937.56	$3,662.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $455.91 / $1,292.07 / $1,660.79	Professional		$455.91	$1,292.07	$1,660.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $252.48 / $664.02 / $1,009.16	Facility		$252.48	$664.02	$1,009.16
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $502.45 / $856.52 / $1,053.04	Professional		$502.45	$856.52	$1,053.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $437.06 / $877.53 / $4,086.48	Facility		$437.06	$877.53	$4,086.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $400.71 / $586.34 / $955.51	Professional		$400.71	$586.34	$955.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $252.48 / $664.02 / $1,009.16	Facility		$252.48	$664.02	$1,009.16
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $502.45 / $856.52 / $1,053.04	Professional		$502.45	$856.52	$1,053.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $877.53 / $1,350.47 / $2,346.65	Professional		$877.53	$1,350.47	$2,346.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $624.54 / $1,713.92 / $4,086.48	Facility		$624.54	$1,713.92	$4,086.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $455.91 / $624.54 / $4,418.01	Professional		$455.91	$624.54	$4,418.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $877.53 / $877.53 / $877.53	Professional		$877.53	$877.53	$877.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $877.53 / $877.53 / $877.53	Professional		$877.53	$877.53	$877.53
United Facility/Professional Professional Modifier Low / Median / High Price $349.59 / $521.46 / $778.03	Professional		$349.59	$521.46	$778.03