Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $297.54 / $629.79 / $3,119.00	Facility		$297.54	$629.79	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $291.20 / $417.07 / $1,425.94	Professional		$291.20	$417.07	$1,425.94
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 $376.93 / $686.63 / $1,886.32	Professional		$376.93	$686.63	$1,886.32
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 $1,124.59 / $1,314.18 / $2,015.99	Facility		$1,124.59	$1,314.18	$2,015.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $461.87 / $1,114.88 / $1,923.86	Professional		$461.87	$1,114.88	$1,923.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $297.54 / $447.86 / $863.20	Facility		$297.54	$447.86	$863.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $300.12 / $521.02 / $4,377.80	Facility		$300.12	$521.02	$4,377.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $422.25 / $908.60 / $3,108.48	Professional		$422.25	$908.60	$3,108.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $248.09 / $808.85	Professional		$52.59	$248.09	$808.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $297.54 / $446.31 / $863.20	Facility		$297.54	$446.31	$863.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $678.24 / $968.75 / $1,412.00	Professional		$678.24	$968.75	$1,412.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,141.64 / $2,141.64 / $2,865.24	Facility		$2,141.64	$2,141.64	$2,865.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $636.24 / $1,782.18 / $3,108.48	Professional		$636.24	$1,782.18	$3,108.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $938.54 / $1,940.15 / $2,694.34	Professional		$938.54	$1,940.15	$2,694.34
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $422.25 / $783.58 / $1,801.21	Professional		$422.25	$783.58	$1,801.21