Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $332.44 / $711.50 / $1,894.00	Facility		$332.44	$711.50	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $330.50 / $359.23 / $1,524.77	Professional		$330.50	$359.23	$1,524.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.39 / $685.52 / $1,942.46	Professional		$340.39	$685.52	$1,942.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,942.50 / $1,942.50 / $1,942.50	Facility		$1,942.50	$1,942.50	$1,942.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $979.52 / $1,144.64 / $1,755.91	Facility		$979.52	$1,144.64	$1,755.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $442.73 / $1,090.09 / $1,617.24	Professional		$442.73	$1,090.09	$1,617.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $316.22 / $420.30 / $790.55	Facility		$316.22	$420.30	$790.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $316.80 / $513.98 / $3,034.00	Facility		$316.80	$513.98	$3,034.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $378.95 / $783.24 / $2,749.68	Professional		$378.95	$783.24	$2,749.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $173.05 / $784.49	Professional		$31.53	$173.05	$784.49
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $316.22 / $410.95 / $790.55	Facility		$316.22	$410.95	$790.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $739.70 / $901.30 / $1,292.31	Professional		$739.70	$901.30	$1,292.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $2,434.02	Facility		$1,722.47	$1,722.47	$2,434.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $674.15 / $1,594.95 / $2,749.68	Professional		$674.15	$1,594.95	$2,749.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,092.36 / $1,092.36 / $1,178.47	Professional		$1,092.36	$1,092.36	$1,178.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,060.29 / $2,188.57 / $2,364.10	Professional		$1,060.29	$2,188.57	$2,364.10
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 $370.28 / $676.01 / $1,563.08	Professional		$370.28	$676.01	$1,563.08