Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.25 / $683.46 / $3,635.15	Facility		$182.25	$683.46	$3,635.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.25 / $474.64 / $1,822.40	Professional		$182.25	$474.64	$1,822.40
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 $242.02 / $420.57 / $1,179.32	Professional		$242.02	$420.57	$1,179.32
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 $1,291.31 / $1,508.99 / $2,314.83	Facility		$1,291.31	$1,508.99	$2,314.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.79 / $832.70 / $2,288.19	Professional		$317.79	$832.70	$2,288.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $182.25 / $402.77 / $975.76	Facility		$182.25	$402.77	$975.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $182.25 / $474.64 / $4,292.39	Facility		$182.25	$474.64	$4,292.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $446.61 / $961.97 / $3,517.20	Professional		$446.61	$961.97	$3,517.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $344.42 / $913.76	Professional		$31.53	$344.42	$913.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $182.25 / $402.77 / $975.76	Facility		$182.25	$402.77	$975.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $433.21 / $824.95 / $1,578.38	Professional		$433.21	$824.95	$1,578.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $876.64 / $876.64 / $1,455.33	Facility		$876.64	$876.64	$1,455.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $416.52 / $1,803.81 / $3,517.20	Professional		$416.52	$1,803.81	$3,517.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $597.04 / $1,183.81 / $3,069.32	Professional		$597.04	$1,183.81	$3,069.32
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $416.53 / $765.07 / $1,919.78	Professional		$416.53	$765.07	$1,919.78