Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $271.99 / $271.99 / $271.99	Facility		$271.99	$271.99	$271.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.45 / $271.99 / $451.60	Professional		$168.45	$271.99	$451.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $539.16 / $593.08 / $981.27	Facility		$539.16	$593.08	$981.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $501.42 / $501.42 / $663.16	Professional		$501.42	$501.42	$663.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $387.87 / $1,153.80 / $1,153.80	Facility		$387.87	$1,153.80	$1,153.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $252.68 / $1,449.00 / $2,250.50	Facility		$252.68	$1,449.00	$2,250.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.10 / $793.91 / $1,020.40	Professional		$194.10	$793.91	$1,020.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $130.22 / $407.99 / $620.03	Facility		$130.22	$407.99	$620.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $308.70 / $404.37 / $646.99	Professional		$308.70	$404.37	$646.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $225.45 / $539.16 / $2,076.44	Facility		$225.45	$539.16	$2,076.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $214.79 / $303.95 / $587.08	Professional		$214.79	$303.95	$587.08
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 $130.22 / $407.99 / $620.03	Facility		$130.22	$407.99	$620.03
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $308.70 / $404.37 / $646.99	Professional		$308.70	$404.37	$646.99
Quartz Facility/Professional Professional Modifier Low / Median / High Price $539.16 / $808.74 / $1,210.46	Professional		$539.16	$808.74	$1,210.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $252.68 / $1,053.04 / $2,076.44	Facility		$252.68	$1,053.04	$2,076.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $194.10 / $252.68 / $2,647.22	Professional		$194.10	$252.68	$2,647.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $539.16 / $539.16 / $539.16	Professional		$539.16	$539.16	$539.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $539.16 / $539.16 / $539.16	Professional		$539.16	$539.16	$539.16
United Facility/Professional Professional Modifier Low / Median / High Price $186.52 / $268.98 / $462.41	Professional		$186.52	$268.98	$462.41