Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.01 / $655.04 / $3,119.00	Facility		$309.01	$655.04	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.01 / $519.73 / $2,491.83	Professional		$309.01	$519.73	$2,491.83
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 $391.45 / $713.10 / $1,811.43	Professional		$391.45	$713.10	$1,811.43
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 $1,385.02 / $1,618.51 / $2,482.83	Facility		$1,385.02	$1,618.51	$2,482.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $545.63 / $1,255.65 / $2,369.36	Professional		$545.63	$1,255.65	$2,369.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $309.01 / $521.84 / $1,058.38	Facility		$309.01	$521.84	$1,058.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $323.50 / $643.83 / $4,377.80	Facility		$323.50	$643.83	$4,377.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $469.43 / $1,095.09 / $3,832.88	Professional		$469.43	$1,095.09	$3,832.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $307.17 / $988.02	Professional		$52.59	$307.17	$988.02
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $309.01 / $521.84 / $1,058.38	Facility		$309.01	$521.84	$1,058.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $743.63 / $1,152.74 / $1,743.63	Professional		$743.63	$1,152.74	$1,743.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,455.33 / $1,455.33 / $1,499.72	Facility		$1,455.33	$1,455.33	$1,499.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $661.75 / $2,194.88 / $3,832.88	Professional		$661.75	$2,194.88	$3,832.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $976.16 / $2,017.95 / $3,318.23	Professional		$976.16	$2,017.95	$3,318.23
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 $484.48 / $973.42 / $2,201.60	Professional		$484.48	$973.42	$2,201.60