Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $274.66 / $274.66 / $274.66	Facility		$274.66	$274.66	$274.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.04 / $274.66 / $460.17	Professional		$228.04	$274.66	$460.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $544.46 / $598.91 / $990.92	Facility		$544.46	$598.91	$990.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $470.90 / $506.35 / $669.68	Professional		$470.90	$506.35	$669.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $391.69 / $1,165.14 / $1,165.14	Facility		$391.69	$1,165.14	$1,165.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $388.32 / $1,202.20 / $2,272.89	Facility		$388.32	$1,202.20	$2,272.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $330.07 / $801.53 / $1,030.44	Professional		$330.07	$801.53	$1,030.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $156.69 / $411.99 / $626.13	Facility		$156.69	$411.99	$626.13
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $311.74 / $531.41 / $653.35	Professional		$311.74	$531.41	$653.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $271.24 / $544.46 / $2,338.92	Facility		$271.24	$544.46	$2,338.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $248.68 / $363.80 / $592.86	Professional		$248.68	$363.80	$592.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $360.00	Professional		$50.00	$70.00	$360.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $156.69 / $411.99 / $626.13	Facility		$156.69	$411.99	$626.13
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $311.74 / $531.41 / $653.35	Professional		$311.74	$531.41	$653.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $544.46 / $837.88 / $1,456.37	Professional		$544.46	$837.88	$1,456.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $388.32 / $1,063.40 / $2,338.92	Facility		$388.32	$1,063.40	$2,338.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $330.07 / $388.32 / $2,746.82	Professional		$330.07	$388.32	$2,746.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $544.46 / $544.46 / $544.46	Professional		$544.46	$544.46	$544.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $544.46 / $544.46 / $544.46	Professional		$544.46	$544.46	$544.46
United Facility/Professional Professional Modifier Low / Median / High Price $216.91 / $326.68 / $544.46	Professional		$216.91	$326.68	$544.46