Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $322.81 / $687.24 / $6,461.00	Facility		$322.81	$687.24	$6,461.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.81 / $505.95 / $1,715.66	Professional		$322.81	$505.95	$1,715.66
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 $408.95 / $744.96 / $1,880.68	Professional		$408.95	$744.96	$1,880.68
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 $1,368.80 / $1,599.55 / $2,453.75	Facility		$1,368.80	$1,599.55	$2,453.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $534.52 / $1,253.18 / $2,338.33	Professional		$534.52	$1,253.18	$2,338.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $317.52 / $505.95 / $1,052.21	Facility		$317.52	$505.95	$1,052.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $322.81 / $622.72 / $4,292.39	Facility		$322.81	$622.72	$4,292.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $509.43 / $1,122.11 / $3,776.00	Professional		$509.43	$1,122.11	$3,776.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $308.07 / $1,009.26	Professional		$52.59	$308.07	$1,009.26
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $322.81 / $505.95 / $1,052.21	Facility		$322.81	$505.95	$1,052.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $773.38 / $1,151.50 / $1,729.02	Professional		$773.38	$1,151.50	$1,729.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,350.75 / $1,350.75 / $2,341.67	Facility		$1,350.75	$1,350.75	$2,341.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $691.73 / $2,166.12 / $3,776.00	Professional		$691.73	$2,166.12	$3,776.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,057.60 / $1,057.60 / $1,676.08	Professional		$1,057.60	$1,057.60	$1,676.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,287.75 / $2,110.96 / $3,274.80	Professional		$1,287.75	$2,110.96	$3,274.80
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 $502.10 / $1,024.58 / $2,201.65	Professional		$502.10	$1,024.58	$2,201.65