Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $466.35 / $939.65 / $3,119.00	Facility		$466.35	$939.65	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $450.27 / $738.05 / $2,296.58	Professional		$450.27	$738.05	$2,296.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,979.00 / $9,096.00 / $15,579.70	Facility		$1,979.00	$9,096.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $590.78 / $970.68 / $2,746.31	Professional		$590.78	$970.68	$2,746.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,995.29 / $5,995.29 / $5,995.29	Facility		$5,995.29	$5,995.29	$5,995.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,006.79 / $2,345.10 / $3,597.44	Facility		$2,006.79	$2,345.10	$3,597.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $730.83 / $1,794.38 / $3,390.66	Professional		$730.83	$1,794.38	$3,390.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $424.75 / $750.93 / $1,510.34	Facility		$424.75	$750.93	$1,510.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $450.27 / $847.97 / $4,377.80	Facility		$450.27	$847.97	$4,377.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $662.48 / $1,548.68 / $5,506.44	Professional		$662.48	$1,548.68	$5,506.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.79 / $422.42 / $1,333.21	Professional		$67.79	$422.42	$1,333.21
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $435.21 / $750.93 / $1,510.34	Facility		$435.21	$750.93	$1,510.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,032.70 / $1,537.60 / $2,411.41	Professional		$1,032.70	$1,537.60	$2,411.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,237.54 / $3,237.54 / $7,676.30	Facility		$3,237.54	$3,237.54	$7,676.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $988.18 / $3,140.96 / $5,506.44	Professional		$988.18	$3,140.96	$5,506.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,570.14 / $1,570.14 / $2,547.58	Professional		$1,570.14	$1,570.14	$2,547.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,105.32 / $2,967.10 / $4,748.53	Professional		$1,105.32	$2,967.10	$4,748.53
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 $662.48 / $1,335.30 / $3,131.77	Professional		$662.48	$1,335.30	$3,131.77