Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $337.05 / $337.05 / $337.05	Facility		$337.05	$337.05	$337.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.33 / $337.05 / $561.64	Professional		$278.33	$337.05	$561.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $668.13 / $734.94 / $1,216.00	Facility		$668.13	$734.94	$1,216.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $621.36 / $621.36 / $821.79	Professional		$621.36	$621.36	$821.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $480.65 / $1,429.80 / $1,429.80	Facility		$480.65	$1,429.80	$1,429.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $375.74 / $1,795.93 / $2,789.33	Facility		$375.74	$1,795.93	$2,789.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.38 / $1,112.75 / $1,264.49	Professional		$319.38	$1,112.75	$1,264.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $193.66 / $505.58 / $768.35	Facility		$193.66	$505.58	$768.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $382.54 / $668.13 / $801.76	Professional		$382.54	$668.13	$801.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $335.24 / $668.13 / $2,890.88	Facility		$335.24	$668.13	$2,890.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $304.01 / $446.41 / $734.94	Professional		$304.01	$446.41	$734.94
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 $193.66 / $505.58 / $768.35	Facility		$193.66	$505.58	$768.35
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $382.54 / $668.13 / $801.76	Professional		$382.54	$668.13	$801.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $668.13 / $1,028.23 / $1,799.63	Professional		$668.13	$1,028.23	$1,799.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $375.74 / $1,304.94 / $2,890.88	Facility		$375.74	$1,304.94	$2,890.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $319.38 / $375.74 / $3,327.29	Professional		$319.38	$375.74	$3,327.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $668.13 / $668.13 / $668.13	Professional		$668.13	$668.13	$668.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $668.13 / $668.13 / $668.13	Professional		$668.13	$668.13	$668.13
United Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $399.99 / $592.38	Professional		$250.00	$399.99	$592.38