Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.52 / $468.35 / $1,894.00	Facility		$167.52	$468.35	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.52 / $289.88 / $939.60	Professional		$167.52	$289.88	$939.60
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 $261.08 / $597.60 / $1,202.69	Professional		$261.08	$597.60	$1,202.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $181.83 / $183.26 / $252.50	Facility		$181.83	$183.26	$252.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $288.51 / $317.36 / $387.76	Professional		$288.51	$317.36	$387.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $847.95 / $990.90 / $1,520.07	Facility		$847.95	$990.90	$1,520.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.68 / $504.89 / $874.28	Professional		$221.68	$504.89	$874.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $196.00 / $369.29 / $849.69	Facility		$196.00	$369.29	$849.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $198.15 / $544.51 / $1,513.00	Facility		$198.15	$544.51	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $285.16 / $586.54 / $1,484.72	Professional		$285.16	$586.54	$1,484.72
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 $196.00 / $369.29 / $849.69	Facility		$196.00	$369.29	$849.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $438.25 / $676.77 / $1,019.06	Professional		$438.25	$676.77	$1,019.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $386.68 / $516.79 / $1,401.12	Facility		$386.68	$516.79	$1,401.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $327.24 / $973.15 / $2,348.96	Professional		$327.24	$973.15	$2,348.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $373.31 / $851.27 / $1,361.79	Professional		$373.31	$851.27	$1,361.79
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $276.02 / $460.56 / $1,127.68	Professional		$276.02	$460.56	$1,127.68