Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.92 / $515.57 / $1,894.00	Facility		$239.92	$515.57	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.00 / $247.04 / $1,078.70	Professional		$227.00	$247.04	$1,078.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.21 / $553.66 / $1,400.85	Professional		$225.21	$553.66	$1,400.85
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 $662.32 / $773.98 / $1,187.30	Facility		$662.32	$773.98	$1,187.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.98 / $738.30 / $1,138.26	Professional		$294.98	$738.30	$1,138.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $229.14 / $283.83 / $519.04	Facility		$229.14	$283.83	$519.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $229.14 / $346.97 / $4,292.39	Facility		$229.14	$346.97	$4,292.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $245.41 / $520.32 / $1,849.04	Professional		$245.41	$520.32	$1,849.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.95 / $180.36 / $482.31	Professional		$30.95	$180.36	$482.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $229.14 / $280.70 / $519.04	Facility		$229.14	$280.70	$519.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $498.55 / $613.75 / $903.99	Professional		$498.55	$613.75	$903.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,460.70 / $1,460.70 / $1,722.47	Facility		$1,460.70	$1,460.70	$1,722.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $454.57 / $1,128.34 / $1,849.04	Professional		$454.57	$1,128.34	$1,849.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $780.87 / $780.87 / $792.05	Professional		$780.87	$780.87	$792.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $734.07 / $1,581.07 / $1,594.07	Professional		$734.07	$1,581.07	$1,594.07
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 $245.41 / $496.47 / $1,012.26	Professional		$245.41	$496.47	$1,012.26