Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $404.55 / $843.01 / $14,482.00	Facility		$404.55	$843.01	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $397.90 / $406.48 / $1,873.52	Professional		$397.90	$406.48	$1,873.52
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 $396.55 / $904.17 / $2,486.32	Professional		$396.55	$904.17	$2,486.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,669.32 / $2,669.32 / $2,669.32	Facility		$2,669.32	$2,669.32	$2,669.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,084.95 / $1,267.84 / $1,944.91	Facility		$1,084.95	$1,267.84	$1,944.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $577.89 / $1,650.08 / $1,875.09	Professional		$577.89	$1,650.08	$1,875.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $404.55 / $515.52 / $936.68	Facility		$404.55	$515.52	$936.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $404.55 / $836.54 / $8,292.34	Facility		$404.55	$836.54	$8,292.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $437.52 / $858.37 / $6,589.56	Professional		$437.52	$858.37	$6,589.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $229.22 / $793.22	Professional		$38.65	$229.22	$793.22
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $404.55 / $515.52 / $936.68	Facility		$404.55	$515.52	$936.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $802.10 / $977.33 / $1,458.96	Professional		$802.10	$977.33	$1,458.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,865.24 / $2,865.24 / $7,909.30	Facility		$2,865.24	$2,865.24	$7,909.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $771.99 / $2,036.25 / $6,589.56	Professional		$771.99	$2,036.25	$6,589.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,333.60 / $1,333.60 / $1,333.60	Professional		$1,333.60	$1,333.60	$1,333.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,256.27 / $2,215.58 / $2,626.01	Professional		$1,256.27	$2,215.58	$2,626.01
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 $432.28 / $864.56 / $1,783.37	Professional		$432.28	$864.56	$1,783.37