Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $355.43 / $767.25 / $14,482.00	Facility		$355.43	$767.25	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $334.63 / $356.62 / $1,449.25	Professional		$334.63	$356.62	$1,449.25
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 $327.08 / $803.64 / $2,057.40	Professional		$327.08	$803.64	$2,057.40
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 $980.42 / $1,145.70 / $1,757.53	Facility		$980.42	$1,145.70	$1,757.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $522.30 / $1,573.50 / $1,848.44	Professional		$522.30	$1,573.50	$1,848.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $345.50 / $472.50 / $813.65	Facility		$345.50	$472.50	$813.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $355.43 / $733.15 / $1,789.00	Facility		$355.43	$733.15	$1,789.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $353.32 / $662.48 / $2,710.72	Professional		$353.32	$662.48	$2,710.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $216.79 / $691.33	Professional		$50.00	$216.79	$691.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $345.50 / $457.91 / $813.65	Facility		$345.50	$457.91	$813.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $729.95 / $889.42 / $1,327.72	Professional		$729.95	$889.42	$1,327.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $4,754.80	Facility		$1,722.47	$1,722.47	$4,754.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $690.36 / $1,647.95 / $2,710.72	Professional		$690.36	$1,647.95	$2,710.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $639.50 / $1,748.62 / $2,348.33	Professional		$639.50	$1,748.62	$2,348.33
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 $353.32 / $642.78 / $1,486.38	Professional		$353.32	$642.78	$1,486.38