Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $325.06 / $681.03 / $6,461.00	Facility		$325.06	$681.03	$6,461.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $325.06 / $446.26 / $1,688.87	Professional		$325.06	$446.26	$1,688.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $10,038.00	Facility		$2,740.00	$4,780.00	$10,038.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $402.09 / $748.34 / $1,984.45	Professional		$402.09	$748.34	$1,984.45
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 $1,203.00 / $1,405.80 / $2,156.53	Facility		$1,203.00	$1,405.80	$2,156.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $500.65 / $1,161.92 / $2,069.21	Professional		$500.65	$1,161.92	$2,069.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $325.06 / $487.59 / $924.97	Facility		$325.06	$487.59	$924.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $330.67 / $527.69 / $11,733.00	Facility		$330.67	$527.69	$11,733.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $449.83 / $951.38 / $3,354.72	Professional		$449.83	$951.38	$3,354.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $342.60 / $948.81	Professional		$28.95	$342.60	$948.81
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $325.06 / $484.29 / $924.97	Facility		$325.06	$484.29	$924.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $731.67 / $1,043.57 / $1,521.04	Professional		$731.67	$1,043.57	$1,521.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,335.32 / $2,335.32 / $2,865.24	Facility		$2,335.32	$2,335.32	$2,865.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $693.04 / $1,916.82 / $3,354.72	Professional		$693.04	$1,916.82	$3,354.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,067.86 / $1,067.86 / $1,468.25	Professional		$1,067.86	$1,067.86	$1,468.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,315.31 / $2,113.32 / $2,897.87	Professional		$1,315.31	$2,113.32	$2,897.87
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $449.83 / $907.78 / $1,850.87	Professional		$449.83	$907.78	$1,850.87