Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $258.07 / $549.86 / $1,894.00	Facility		$258.07	$549.86	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.07 / $370.23 / $1,471.04	Professional		$258.07	$370.23	$1,471.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $326.93 / $595.54 / $1,680.75	Professional		$326.93	$595.54	$1,680.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $743.62 / $743.62 / $743.62	Facility		$743.62	$743.62	$743.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,004.75 / $1,174.13 / $1,801.14	Facility		$1,004.75	$1,174.13	$1,801.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.66 / $981.08 / $1,721.00	Professional		$421.66	$981.08	$1,721.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $258.07 / $416.21 / $780.39	Facility		$258.07	$416.21	$780.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $266.95 / $491.41 / $7,160.00	Facility		$266.95	$491.41	$7,160.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $402.82 / $855.99 / $2,778.56	Professional		$402.82	$855.99	$2,778.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $219.47 / $698.83	Professional		$52.59	$219.47	$698.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $258.07 / $414.94 / $780.39	Facility		$258.07	$414.94	$780.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $608.54 / $863.28 / $1,269.22	Professional		$608.54	$863.28	$1,269.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $504.46 / $504.46 / $1,846.50	Facility		$504.46	$504.46	$1,846.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $559.91 / $1,594.26 / $2,778.56	Professional		$559.91	$1,594.26	$2,778.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $855.11 / $855.11 / $1,235.34	Professional		$855.11	$855.11	$1,235.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $928.45 / $1,684.18 / $2,410.16	Professional		$928.45	$1,684.18	$2,410.16
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $371.83 / $760.88 / $1,736.71	Professional		$371.83	$760.88	$1,736.71