Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $377.67 / $806.38 / $1,894.00	Facility		$377.67	$806.38	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $376.42 / $421.55 / $1,720.99	Professional		$376.42	$421.55	$1,720.99
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 $386.54 / $871.55 / $2,201.44	Professional		$386.54	$871.55	$2,201.44
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 $1,115.58 / $1,303.65 / $1,999.83	Facility		$1,115.58	$1,303.65	$1,999.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $500.23 / $1,250.54 / $1,878.84	Professional		$500.23	$1,250.54	$1,878.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $342.16 / $466.84 / $871.70	Facility		$342.16	$466.84	$871.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $358.39 / $566.51 / $1,510.68	Facility		$358.39	$566.51	$1,510.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $421.32 / $890.81 / $3,130.64	Professional		$421.32	$890.81	$3,130.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $255.82 / $821.10	Professional		$52.59	$255.82	$821.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $358.39 / $466.84 / $871.70	Facility		$358.39	$466.84	$871.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $841.10 / $1,024.84 / $1,469.47	Professional		$841.10	$1,024.84	$1,469.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $2,757.54	Facility		$1,722.47	$1,722.47	$2,757.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $767.84 / $1,800.20 / $3,130.64	Professional		$767.84	$1,800.20	$3,130.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,237.99 / $1,237.99 / $1,343.14	Professional		$1,237.99	$1,237.99	$1,343.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,196.63 / $2,478.07 / $2,692.61	Professional		$1,196.63	$2,478.07	$2,692.61
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $414.28 / $761.74 / $1,707.73	Professional		$414.28	$761.74	$1,707.73