Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $394.77 / $829.13 / $14,482.00	Facility		$394.77	$829.13	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $376.33 / $401.36 / $1,803.11	Professional		$376.33	$401.36	$1,803.11
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 $383.31 / $911.01 / $2,416.77	Professional		$383.31	$911.01	$2,416.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,198.35 / $2,198.35 / $2,198.35	Facility		$2,198.35	$2,198.35	$2,198.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,056.10 / $1,234.15 / $1,893.22	Facility		$1,056.10	$1,234.15	$1,893.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $565.04 / $1,614.31 / $1,834.44	Professional		$565.04	$1,614.31	$1,834.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $368.50 / $494.98 / $849.49	Facility		$368.50	$494.98	$849.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $369.58 / $792.28 / $5,261.00	Facility		$369.58	$792.28	$5,261.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $425.18 / $764.44 / $2,999.60	Professional		$425.18	$764.44	$2,999.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $306.80 / $829.85	Professional		$62.75	$306.80	$829.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $368.50 / $471.68 / $849.49	Facility		$368.50	$471.68	$849.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $791.70 / $964.66 / $1,440.04	Professional		$791.70	$964.66	$1,440.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,015.89 / $2,015.89 / $5,564.75	Facility		$2,015.89	$2,015.89	$5,564.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $755.26 / $1,886.10 / $2,999.60	Professional		$755.26	$1,886.10	$2,999.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,296.28 / $1,296.28 / $1,296.28	Professional		$1,296.28	$1,296.28	$1,296.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $369.49 / $1,961.46 / $2,569.09	Professional		$369.49	$1,961.46	$2,569.09
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 $425.18 / $764.44 / $1,716.35	Professional		$425.18	$764.44	$1,716.35