Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.16 / $377.10 / $1,726.48	Facility		$142.16	$377.10	$1,726.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.05 / $273.55 / $1,165.00	Professional		$147.05	$273.55	$1,165.00
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 $230.67 / $507.10 / $1,083.50	Professional		$230.67	$507.10	$1,083.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $153.88 / $155.24 / $213.49	Facility		$153.88	$155.24	$213.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $258.32 / $284.14 / $345.95	Professional		$258.32	$284.14	$345.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $762.35 / $890.86 / $1,366.61	Facility		$762.35	$890.86	$1,366.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.54 / $434.47 / $785.63	Professional		$186.54	$434.47	$785.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $166.33 / $330.65 / $759.57	Facility		$166.33	$330.65	$759.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $179.19 / $461.64 / $1,513.00	Facility		$179.19	$461.64	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $256.81 / $497.12 / $1,259.59	Professional		$256.81	$497.12	$1,259.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $189.02 / $525.89	Professional		$26.80	$189.02	$525.89
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $166.33 / $330.65 / $759.57	Facility		$166.33	$330.65	$759.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $372.62 / $573.34 / $911.96	Professional		$372.62	$573.34	$911.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $327.56 / $437.78 / $1,191.11	Facility		$327.56	$437.78	$1,191.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $279.85 / $820.30 / $2,106.71	Professional		$279.85	$820.30	$2,106.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $313.23 / $722.48 / $1,222.81	Professional		$313.23	$722.48	$1,222.81
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 $237.12 / $409.55 / $990.44	Professional		$237.12	$409.55	$990.44