Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $403.32 / $852.84 / $1,539.80	Facility		$403.32	$852.84	$1,539.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $403.32 / $453.14 / $1,771.25	Professional		$403.32	$453.14	$1,771.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $509.60 / $930.74 / $2,623.81	Professional		$509.60	$930.74	$2,623.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $319.44 / $319.44 / $319.44	Facility		$319.44	$319.44	$319.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,094.85 / $1,279.43 / $1,962.68	Facility		$1,094.85	$1,279.43	$1,962.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $621.04 / $1,466.19 / $1,903.65	Professional		$621.04	$1,466.19	$1,903.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $403.32 / $559.38 / $1,049.48	Facility		$403.32	$559.38	$1,049.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $392.50 / $614.52 / $1,590.00	Facility		$392.50	$614.52	$1,590.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $507.57 / $1,018.77 / $3,178.50	Professional		$507.57	$1,018.77	$3,178.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $309.23 / $856.16	Professional		$62.75	$309.23	$856.16
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $403.32 / $558.62 / $1,049.48	Facility		$403.32	$558.62	$1,049.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $837.85 / $1,031.46 / $1,612.34	Professional		$837.85	$1,031.46	$1,612.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $2,449.80	Facility		$264.92	$264.92	$2,449.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $772.92 / $2,023.90 / $3,178.50	Professional		$772.92	$2,023.90	$3,178.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,270.92 / $2,629.12 / $2,665.98	Professional		$1,270.92	$2,629.12	$2,665.98
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $486.84 / $861.56 / $1,880.55	Professional		$486.84	$861.56	$1,880.55