Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.76 / $331.18 / $1,894.00	Facility		$158.76	$331.18	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.76 / $251.83 / $847.30	Professional		$158.76	$251.83	$847.30
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 $236.50 / $484.30 / $1,220.18	Professional		$236.50	$484.30	$1,220.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $427.90 / $427.90 / $427.90	Facility		$427.90	$427.90	$427.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $683.05 / $798.20 / $1,224.45	Facility		$683.05	$798.20	$1,224.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.36 / $608.85 / $1,170.71	Professional		$265.36	$608.85	$1,170.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $158.76 / $256.66 / $513.67	Facility		$158.76	$256.66	$513.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $160.94 / $316.42 / $2,951.70	Facility		$160.94	$316.42	$2,951.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $256.24 / $542.92 / $1,894.40	Professional		$256.24	$542.92	$1,894.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.44 / $258.38 / $515.75	Professional		$123.44	$258.38	$515.75
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $158.76 / $256.66 / $513.67	Facility		$158.76	$256.66	$513.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $369.15 / $565.73 / $838.65	Professional		$369.15	$565.73	$838.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $321.69 / $321.69 / $765.40	Facility		$321.69	$321.69	$765.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $340.99 / $1,084.50 / $1,894.40	Professional		$340.99	$1,084.50	$1,894.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $522.07 / $522.07 / $834.08	Professional		$522.07	$522.07	$834.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $528.70 / $1,039.27 / $1,639.58	Professional		$528.70	$1,039.27	$1,639.58
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 $256.24 / $476.27 / $1,097.09	Professional		$256.24	$476.27	$1,097.09