Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.61 / $349.72 / $1,894.00	Facility		$164.61	$349.72	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.61 / $309.58 / $883.40	Professional		$164.61	$309.58	$883.40
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 $208.53 / $379.87 / $1,006.67	Professional		$208.53	$379.87	$1,006.67
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 $838.04 / $979.32 / $1,502.30	Facility		$838.04	$979.32	$1,502.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.22 / $677.44 / $1,427.50	Professional		$288.22	$677.44	$1,427.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $133.57 / $309.58 / $638.08	Facility		$133.57	$309.58	$638.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $155.43 / $340.31 / $4,377.80	Facility		$155.43	$340.31	$4,377.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $291.35 / $664.70 / $2,301.28	Professional		$291.35	$664.70	$2,301.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $230.32 / $636.77	Professional		$28.95	$230.32	$636.77
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $133.57 / $309.58 / $638.08	Facility		$133.57	$309.58	$638.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $395.84 / $652.83 / $1,048.88	Professional		$395.84	$652.83	$1,048.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,200.90 / $1,200.90 / $2,469.60	Facility		$1,200.90	$1,200.90	$2,469.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $368.92 / $1,257.83 / $2,301.28	Professional		$368.92	$1,257.83	$2,301.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $541.72 / $541.72 / $1,031.54	Professional		$541.72	$541.72	$1,031.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $657.65 / $1,078.14 / $1,999.14	Professional		$657.65	$1,078.14	$1,999.14
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 $292.64 / $535.58 / $1,299.84	Professional		$292.64	$535.58	$1,299.84