Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.46 / $347.58 / $1,894.00	Facility		$163.46	$347.58	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.46 / $299.39 / $876.73	Professional		$163.46	$299.39	$876.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,314.00 / $2,550.00 / $4,471.00	Facility		$1,314.00	$2,550.00	$4,471.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.07 / $377.22 / $954.46	Professional		$207.07	$377.22	$954.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $822.21 / $822.21 / $822.21	Facility		$822.21	$822.21	$822.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $811.01 / $947.73 / $1,453.84	Facility		$811.01	$947.73	$1,453.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.93 / $672.77 / $1,381.94	Professional		$280.93	$672.77	$1,381.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $132.57 / $299.39 / $620.73	Facility		$132.57	$299.39	$620.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $154.47 / $332.13 / $3,034.00	Facility		$154.47	$332.13	$3,034.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $274.27 / $617.64 / $2,228.40	Professional		$274.27	$617.64	$2,228.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $234.64 / $623.23	Professional		$31.53	$234.64	$623.23
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $154.47 / $299.39 / $620.73	Facility		$154.47	$299.39	$620.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $393.55 / $648.01 / $1,015.15	Professional		$393.55	$648.01	$1,015.15
Quartz Facility/Professional Facility Modifier Low / Median / High Price $794.60 / $794.60 / $1,455.33	Facility		$794.60	$794.60	$1,455.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $351.11 / $1,248.72 / $2,228.40	Professional		$351.11	$1,248.72	$2,228.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $536.75 / $536.75 / $997.51	Professional		$536.75	$536.75	$997.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $653.13 / $1,070.67 / $1,935.37	Professional		$653.13	$1,070.67	$1,935.37
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $274.27 / $506.92 / $1,244.99	Professional		$274.27	$506.92	$1,244.99