Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.19 / $1,894.00 / $14,482.00	Facility		$112.19	$1,894.00	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.19 / $152.62 / $582.40	Professional		$112.19	$152.62	$582.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,749.00 / $5,749.00 / $6,159.00	Facility		$5,749.00	$5,749.00	$6,159.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.43 / $224.38 / $693.46	Professional		$114.43	$224.38	$693.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $110.36 / $132.43 / $166.91	Facility		$110.36	$132.43	$166.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.72 / $109.96 / $150.19	Professional		$104.72	$109.96	$150.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $299.17 / $349.61 / $536.29	Facility		$299.17	$349.61	$536.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.46 / $452.09 / $568.38	Professional		$167.46	$452.09	$568.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $112.19 / $163.83 / $247.94	Facility		$112.19	$163.83	$247.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.94 / $231.88 / $1,789.00	Facility		$114.94	$231.88	$1,789.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.13 / $232.96 / $1,634.59	Professional		$128.13	$232.96	$1,634.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $112.19 / $160.19 / $247.94	Facility		$112.19	$160.19	$247.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $220.93 / $280.37 / $402.00	Professional		$220.93	$280.37	$402.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $1,300.00 / $1,300.00	Facility		$1,300.00	$1,300.00	$1,300.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $206.62 / $562.29 / $1,634.59	Professional		$206.62	$562.29	$1,634.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $344.48 / $397.16 / $577.58	Professional		$344.48	$397.16	$577.58
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $129.60 / $246.29 / $539.62	Professional		$129.60	$246.29	$539.62