Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $421.30 / $899.35 / $1,894.00	Facility		$421.30	$899.35	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $418.62 / $465.83 / $1,912.67	Professional		$418.62	$465.83	$1,912.67
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 $439.64 / $960.48 / $2,456.44	Professional		$439.64	$960.48	$2,456.44
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 $1,269.68 / $1,483.72 / $2,276.06	Facility		$1,269.68	$1,483.72	$2,276.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $542.60 / $1,535.50 / $2,184.92	Professional		$542.60	$1,535.50	$2,184.92
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $399.71 / $540.00 / $991.04	Facility		$399.71	$540.00	$991.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $399.71 / $631.95 / $1,513.00	Facility		$399.71	$631.95	$1,513.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $477.10 / $1,008.49 / $3,554.00	Professional		$477.10	$1,008.49	$3,554.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $291.90 / $947.18	Professional		$52.59	$291.90	$947.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $399.71 / $530.16 / $991.04	Facility		$399.71	$530.16	$991.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $954.20 / $1,162.66 / $1,667.06	Professional		$954.20	$1,162.66	$1,667.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $2,050.32	Facility		$1,722.47	$1,722.47	$2,050.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $872.58 / $2,024.01 / $3,554.00	Professional		$872.58	$2,024.01	$3,554.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,381.39 / $1,381.39 / $1,526.78	Professional		$1,381.39	$1,381.39	$1,526.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,216.84 / $2,765.16 / $3,059.92	Professional		$1,216.84	$2,765.16	$3,059.92
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 $476.34 / $855.33 / $2,000.03	Professional		$476.34	$855.33	$2,000.03