Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.01 / $318.47 / $1,894.00	Facility		$152.01	$318.47	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.01 / $255.46 / $829.72	Professional		$152.01	$255.46	$829.72
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 $192.56 / $350.79 / $942.63	Professional		$192.56	$350.79	$942.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $483.49 / $483.49 / $483.49	Facility		$483.49	$483.49	$483.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $688.46 / $804.51 / $1,234.15	Facility		$688.46	$804.51	$1,234.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $248.28 / $609.71 / $1,179.03	Professional		$248.28	$609.71	$1,179.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $141.54 / $255.46 / $523.24	Facility		$141.54	$255.46	$523.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $146.01 / $298.89 / $3,034.00	Facility		$146.01	$298.89	$3,034.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $264.89 / $558.55 / $1,905.84	Professional		$264.89	$558.55	$1,905.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $180.36 / $499.03	Professional		$28.95	$180.36	$499.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $143.55 / $255.46 / $523.24	Facility		$143.55	$255.46	$523.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $358.47 / $555.67 / $858.89	Professional		$358.47	$555.67	$858.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $344.95 / $344.95 / $1,092.30	Facility		$344.95	$344.95	$1,092.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $323.30 / $1,092.20 / $1,905.84	Professional		$323.30	$1,092.20	$1,905.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $474.58 / $985.88 / $1,651.20	Professional		$474.58	$985.88	$1,651.20
United Facility/Professional Facility Modifier Low / Median / High Price $1,957.00 / $3,068.00 / $4,295.00	Facility		$1,957.00	$3,068.00	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $264.18 / $498.86 / $1,129.54	Professional		$264.18	$498.86	$1,129.54