Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $318.82 / $676.80 / $3,119.00	Facility		$318.82	$676.80	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.51 / $480.05 / $1,458.33	Professional		$288.51	$480.05	$1,458.33
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 $403.88 / $735.73 / $1,879.67	Professional		$403.88	$735.73	$1,879.67
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 $1,368.80 / $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 $526.39 / $1,244.93 / $2,346.59	Professional		$526.39	$1,244.93	$2,346.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $283.62 / $516.52 / $1,048.73	Facility		$283.62	$516.52	$1,048.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $293.58 / $596.61 / $4,292.39	Facility		$293.58	$596.61	$4,292.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $363.53 / $1,055.24 / $3,804.40	Professional		$363.53	$1,055.24	$3,804.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $403.24 / $1,056.67	Professional		$31.53	$403.24	$1,056.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $283.62 / $516.52 / $1,048.73	Facility		$283.62	$516.52	$1,048.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $771.09 / $1,178.36 / $1,736.89	Professional		$771.09	$1,178.36	$1,736.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,455.33 / $1,455.33 / $1,557.32	Facility		$1,455.33	$1,455.33	$1,557.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $684.69 / $2,173.77 / $3,804.40	Professional		$684.69	$2,173.77	$3,804.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,008.58 / $2,087.87 / $3,286.34	Professional		$1,008.58	$2,087.87	$3,286.34
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 $449.94 / $871.63 / $2,114.98	Professional		$449.94	$871.63	$2,114.98