Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $413.97 / $413.97 / $413.97	Facility		$413.97	$413.97	$413.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.26 / $421.93 / $687.34	Professional		$320.26	$421.93	$687.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $820.61 / $902.67 / $1,493.51	Facility		$820.61	$902.67	$1,493.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $738.54 / $763.17 / $1,009.35	Professional		$738.54	$763.17	$1,009.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $590.35 / $1,756.11 / $1,756.11	Facility		$590.35	$1,756.11	$1,756.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $502.54 / $2,205.04 / $3,424.73	Facility		$502.54	$2,205.04	$3,424.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $427.16 / $1,208.25 / $1,553.08	Professional		$427.16	$1,208.25	$1,553.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $226.26 / $620.96 / $943.70	Facility		$226.26	$620.96	$943.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $469.86 / $702.52 / $984.73	Professional		$469.86	$702.52	$984.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $391.67 / $820.61 / $3,658.96	Facility		$391.67	$820.61	$3,658.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $355.18 / $527.95 / $893.54	Professional		$355.18	$527.95	$893.54
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 $226.26 / $620.96 / $943.70	Facility		$226.26	$620.96	$943.70
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $469.86 / $702.52 / $984.73	Professional		$469.86	$702.52	$984.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $820.61 / $1,262.89 / $2,102.75	Professional		$820.61	$1,262.89	$2,102.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $502.54 / $1,602.76 / $3,658.96	Facility		$502.54	$1,602.76	$3,658.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $427.16 / $502.54 / $4,664.72	Professional		$427.16	$502.54	$4,664.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $820.61 / $820.61 / $820.61	Professional		$820.61	$820.61	$820.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $820.61 / $820.61 / $820.61	Professional		$820.61	$820.61	$820.61
United Facility/Professional Professional Modifier Low / Median / High Price $292.07 / $527.41 / $893.54	Professional		$292.07	$527.41	$893.54