Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $320.74 / $958.03 / $3,119.00	Facility		$320.74	$958.03	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.74 / $443.71 / $1,513.00	Professional		$320.74	$443.71	$1,513.00
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 $427.83 / $878.34 / $2,332.46	Professional		$427.83	$878.34	$2,332.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,507.48 / $1,507.48 / $1,507.48	Facility		$1,507.48	$1,507.48	$1,507.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,239.94 / $1,448.97 / $2,337.14	Facility		$1,239.94	$1,448.97	$2,337.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $586.41 / $1,368.04 / $2,217.21	Professional		$586.41	$1,368.04	$2,217.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $320.74 / $478.39 / $740.82	Facility		$320.74	$478.39	$740.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $362.74 / $740.82 / $5,801.00	Facility		$362.74	$740.82	$5,801.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $507.52 / $1,521.30 / $2,463.04	Professional		$507.52	$1,521.30	$2,463.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.56 / $288.00 / $911.63	Professional		$54.56	$288.00	$911.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $320.74 / $478.39 / $740.82	Facility		$320.74	$478.39	$740.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $768.42 / $1,122.46 / $1,682.41	Professional		$768.42	$1,122.46	$1,682.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,964.15 / $1,964.15 / $1,964.15	Facility		$1,964.15	$1,964.15	$1,964.15
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $155.02 / $155.02 / $155.02	Facility	AS	$155.02	$155.02	$155.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $597.32 / $1,565.20 / $3,474.64	Professional		$597.32	$1,565.20	$3,474.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,057.47 / $2,094.65 / $2,987.57	Professional		$1,057.47	$2,094.65	$2,987.57
United Facility/Professional Facility Modifier Low / Median / High Price $2,976.00 / $4,155.00 / $5,865.00	Facility		$2,976.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $507.52 / $1,377.92 / $2,293.92	Professional		$507.52	$1,377.92	$2,293.92