Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.27 / $471.26 / $4,257.83	Facility		$126.27	$471.26	$4,257.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.59 / $375.72 / $1,515.90	Professional		$104.59	$375.72	$1,515.90
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 $206.41 / $579.02 / $2,038.27	Professional		$206.41	$579.02	$2,038.27
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 $1,024.57 / $1,197.30 / $1,836.68	Facility		$1,024.57	$1,197.30	$1,836.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.26 / $581.33 / $1,743.50	Professional		$219.26	$581.33	$1,743.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $126.27 / $341.33 / $853.33	Facility		$126.27	$341.33	$853.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.59 / $388.02 / $4,292.39	Facility		$126.59	$388.02	$4,292.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $489.36 / $1,393.00 / $5,520.83	Professional		$489.36	$1,393.00	$5,520.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $187.77 / $336.33 / $790.39	Professional		$187.77	$336.33	$790.39
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $126.27 / $341.33 / $853.33	Facility		$126.27	$341.33	$853.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $293.64 / $532.53 / $1,245.60	Professional		$293.64	$532.53	$1,245.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $612.24 / $612.24 / $1,455.33	Facility		$612.24	$612.24	$1,455.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $278.58 / $1,414.80 / $5,520.83	Professional		$278.58	$1,414.80	$5,520.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $416.07 / $814.15 / $2,441.69	Professional		$416.07	$814.15	$2,441.69
United Facility/Professional Facility Modifier Low / Median / High Price $2,723.00 / $3,912.00 / $5,865.00	Facility		$2,723.00	$3,912.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $451.70 / $935.41 / $2,140.90	Professional		$451.70	$935.41	$2,140.90