Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.44 / $722.40 / $1,894.00	Facility		$164.44	$722.40	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.44 / $275.11 / $1,164.50	Professional		$164.44	$275.11	$1,164.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.83 / $588.13 / $1,183.28	Professional		$256.83	$588.13	$1,183.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $178.63 / $180.15 / $247.71	Facility		$178.63	$180.15	$247.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $283.85 / $312.24 / $380.97	Professional		$283.85	$312.24	$380.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $834.44 / $975.11 / $1,495.84	Facility		$834.44	$975.11	$1,495.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.53 / $496.73 / $805.78	Professional		$217.53	$496.73	$805.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $192.39 / $363.33 / $835.62	Facility		$192.39	$363.33	$835.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $198.21 / $535.50 / $1,590.00	Facility		$198.21	$535.50	$1,590.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $276.93 / $557.14 / $1,458.32	Professional		$276.93	$557.14	$1,458.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $189.02 / $588.93	Professional		$26.80	$189.02	$588.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $192.39 / $363.33 / $835.62	Facility		$192.39	$363.33	$835.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $430.71 / $664.40 / $1,001.75	Professional		$430.71	$664.40	$1,001.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $380.12 / $508.02 / $1,375.92	Facility		$380.12	$508.02	$1,375.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $321.64 / $956.40 / $2,310.32	Professional		$321.64	$956.40	$2,310.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $366.97 / $836.70 / $1,339.94	Professional		$366.97	$836.70	$1,339.94
United Facility/Professional Facility Modifier Low / Median / High Price $785.00 / $1,370.00 / $2,202.90	Facility		$785.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $261.98 / $431.78 / $1,104.32	Professional		$261.98	$431.78	$1,104.32