Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $482.00 / $482.00 / $482.00	Facility		$482.00	$482.00	$482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $337.78 / $528.69 / $1,039.02	Professional		$337.78	$528.69	$1,039.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $955.47 / $1,051.02 / $1,738.96	Facility		$955.47	$1,051.02	$1,738.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $826.38 / $888.59 / $1,175.22	Professional		$826.38	$888.59	$1,175.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $687.36 / $2,044.71 / $2,044.71	Facility		$687.36	$2,044.71	$2,044.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $451.71 / $2,568.19 / $3,988.76	Facility		$451.71	$2,568.19	$3,988.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $383.95 / $1,406.84 / $1,808.31	Professional		$383.95	$1,406.84	$1,808.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $235.05 / $723.00 / $1,098.79	Facility		$235.05	$723.00	$1,098.79
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $547.08 / $954.86 / $1,146.56	Professional		$547.08	$954.86	$1,146.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $406.87 / $955.47 / $3,676.21	Facility		$406.87	$955.47	$3,676.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.65 / $548.57 / $1,040.39	Professional		$380.65	$548.57	$1,040.39
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 $235.05 / $723.00 / $1,098.79	Facility		$235.05	$723.00	$1,098.79
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $547.08 / $954.86 / $1,146.56	Professional		$547.08	$954.86	$1,146.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $955.47 / $1,433.21 / $2,185.05	Professional		$955.47	$1,433.21	$2,185.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $451.71 / $1,866.16 / $3,676.21	Facility		$451.71	$1,866.16	$3,676.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $383.95 / $451.71 / $4,583.33	Professional		$383.95	$451.71	$4,583.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $955.47 / $955.47 / $955.47	Professional		$955.47	$955.47	$955.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $955.47 / $955.47 / $955.47	Professional		$955.47	$955.47	$955.47
United Facility/Professional Professional Modifier Low / Median / High Price $329.06 / $485.45 / $910.22	Professional		$329.06	$485.45	$910.22