Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $235.26 / $947.00 / $8,878.33	Facility		$235.26	$947.00	$8,878.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.26 / $866.40 / $5,423.00	Professional		$235.26	$866.40	$5,423.00
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $56.34 / $174.76 / $622.58	Professional	AS	$56.34	$174.76	$622.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.06 / $493.54 / $1,466.69	Professional		$239.06	$493.54	$1,466.69
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $33.46 / $76.00 / $212.39	Professional	AS	$33.46	$76.00	$212.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $245.60 / $294.72 / $382.80	Facility		$245.60	$294.72	$382.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.37 / $233.75 / $333.26	Professional		$218.37	$233.75	$333.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $613.66 / $717.11 / $1,100.07	Facility		$613.66	$717.11	$1,100.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $376.27 / $992.82 / $1,128.20	Professional		$376.27	$992.82	$1,128.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $235.26 / $329.36 / $542.01	Facility		$235.26	$329.36	$542.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $238.65 / $491.33 / $1,789.00	Facility		$238.65	$491.33	$1,789.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $286.10 / $490.32 / $1,822.88	Professional		$286.10	$490.32	$1,822.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.25 / $246.86 / $549.67	Professional		$126.25	$246.86	$549.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $235.26 / $329.36 / $542.01	Facility		$235.26	$329.36	$542.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $502.79 / $613.01 / $915.10	Professional		$502.79	$613.01	$915.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,171.68 / $1,171.68 / $1,171.68	Facility		$1,171.68	$1,171.68	$1,171.68
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $732.30 / $732.30 / $732.30	Facility	62	$732.30	$732.30	$732.30
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $117.17 / $117.17 / $117.17	Facility	AS	$117.17	$117.17	$117.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $433.50 / $1,186.59 / $1,822.88	Professional		$433.50	$1,186.59	$1,822.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $732.19 / $1,208.71 / $1,520.21	Professional		$732.19	$1,208.71	$1,520.21
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $283.45 / $490.32 / $1,079.81	Professional		$283.45	$490.32	$1,079.81