Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.81 / $471.49 / $1,894.00	Facility		$85.81	$471.49	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.95 / $187.28 / $620.00	Professional		$75.95	$187.28	$620.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.44 / $352.44 / $1,025.38	Professional		$139.44	$352.44	$1,025.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,507.48 / $1,507.48 / $1,507.48	Facility		$1,507.48	$1,507.48	$1,507.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $626.28 / $731.86 / $1,122.69	Facility		$626.28	$731.86	$1,122.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.59 / $392.99 / $1,067.69	Professional		$156.59	$392.99	$1,067.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $83.47 / $189.64 / $473.80	Facility		$83.47	$189.64	$473.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.49 / $229.41 / $3,034.00	Facility		$85.49	$229.41	$3,034.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $212.80 / $542.72 / $1,717.20	Professional		$212.80	$542.72	$1,717.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.51 / $230.46 / $522.59	Professional		$132.51	$230.46	$522.59
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $83.47 / $189.64 / $473.80	Facility		$83.47	$189.64	$473.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $197.54 / $360.01 / $735.62	Professional		$197.54	$360.01	$735.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $418.95 / $418.95 / $1,455.33	Facility		$418.95	$418.95	$1,455.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $188.33 / $866.67 / $1,717.20	Professional		$188.33	$866.67	$1,717.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $239.42 / $550.38 / $1,495.24	Professional		$239.42	$550.38	$1,495.24
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $212.80 / $461.36 / $1,061.32	Professional		$212.80	$461.36	$1,061.32