Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.75 / $826.26 / $3,119.00	Facility		$170.75	$826.26	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $320.87 / $2,030.00	Professional		$70.73	$320.87	$2,030.00
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 $158.97 / $474.51 / $1,736.88	Professional		$158.97	$474.51	$1,736.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $78.61 / $118.77 / $118.77	Facility		$78.61	$118.77	$118.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $334.07 / $458.37 / $708.49	Professional		$334.07	$458.37	$708.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $993.03 / $1,160.44 / $1,871.75	Facility		$993.03	$1,160.44	$1,871.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.34 / $466.64 / $1,279.78	Professional		$156.34	$466.64	$1,279.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.89 / $176.01 / $664.31	Facility		$75.89	$176.01	$664.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.07 / $703.59 / $4,130.00	Facility		$91.07	$703.59	$4,130.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $500.84 / $1,287.63 / $2,010.29	Professional		$500.84	$1,287.63	$2,010.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $363.08 / $938.09	Professional		$85.00	$363.08	$938.09
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $75.89 / $176.01 / $664.31	Facility		$75.89	$176.01	$664.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $189.30 / $358.01 / $1,253.24	Professional		$189.30	$358.01	$1,253.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $387.04 / $387.04 / $387.04	Facility		$387.04	$387.04	$387.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $159.81 / $965.91 / $2,694.24	Professional		$159.81	$965.91	$2,694.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $296.94 / $801.77 / $1,577.18	Professional		$296.94	$801.77	$1,577.18
United Facility/Professional Facility Modifier Low / Median / High Price $2,257.00 / $3,088.30 / $4,295.00	Facility		$2,257.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $475.87 / $1,287.63 / $1,866.16	Professional		$475.87	$1,287.63	$1,866.16