Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.50 / $414.56 / $14,482.00	Facility		$195.50	$414.56	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.50 / $195.50 / $869.91	Professional		$184.50	$195.50	$869.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.22 / $451.16 / $1,132.64	Professional		$182.22	$451.16	$1,132.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,554.79 / $1,554.79 / $1,554.79	Facility		$1,554.79	$1,554.79	$1,554.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $533.46 / $623.39 / $956.30	Facility		$533.46	$623.39	$956.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.10 / $806.01 / $915.93	Professional		$281.10	$806.01	$915.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $194.77 / $255.27 / $460.63	Facility		$194.77	$255.27	$460.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $194.77 / $396.14 / $5,261.00	Facility		$194.77	$396.14	$5,261.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $194.52 / $386.87 / $8,054.09	Professional		$194.52	$386.87	$8,054.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.95 / $148.14 / $395.88	Professional		$30.95	$148.14	$395.88
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $194.77 / $255.11 / $460.63	Facility		$194.77	$255.11	$460.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $393.25 / $479.16 / $715.29	Professional		$393.25	$479.16	$715.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,350.75 / $1,350.75 / $3,728.65	Facility		$1,350.75	$1,350.75	$3,728.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $377.10 / $1,493.25 / $8,054.09	Professional		$377.10	$1,493.25	$8,054.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $636.96 / $636.96 / $636.96	Professional		$636.96	$636.96	$636.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $548.51 / $975.49 / $1,282.71	Professional		$548.51	$975.49	$1,282.71
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 $194.52 / $379.06 / $828.05	Professional		$194.52	$379.06	$828.05