Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.72 / $812.54 / $6,461.00	Facility		$207.72	$812.54	$6,461.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.99 / $369.62 / $1,684.00	Professional		$207.99	$369.62	$1,684.00
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 $348.14 / $746.93 / $1,545.08	Professional		$348.14	$746.93	$1,545.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $223.45 / $225.23 / $310.27	Facility		$223.45	$225.23	$310.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $361.13 / $397.24 / $484.92	Professional		$361.13	$397.24	$484.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,065.11 / $1,244.68 / $1,909.37	Facility		$1,065.11	$1,244.68	$1,909.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.25 / $628.14 / $1,168.68	Professional		$280.25	$628.14	$1,168.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $243.03 / $462.25 / $1,063.10	Facility		$243.03	$462.25	$1,063.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $256.11 / $666.15 / $1,590.00	Facility		$256.11	$666.15	$1,590.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $378.91 / $763.36 / $1,917.52	Professional		$378.91	$763.36	$1,917.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.98 / $282.77 / $754.06	Professional		$29.98	$282.77	$754.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $243.03 / $462.25 / $1,063.10	Facility		$243.03	$462.25	$1,063.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $546.87 / $831.91 / $1,275.44	Professional		$546.87	$831.91	$1,275.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $475.24 / $635.15 / $1,151.83	Facility		$475.24	$635.15	$1,151.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $422.13 / $1,210.80 / $2,948.08	Professional		$422.13	$1,210.80	$2,948.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $463.89 / $1,050.32 / $1,710.18	Professional		$463.89	$1,050.32	$1,710.18
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,423.00 / $2,202.90	Facility		$1,008.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $361.39 / $594.67 / $1,517.61	Professional		$361.39	$594.67	$1,517.61