Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $479.70 / $1,021.01 / $1,949.98	Facility		$479.70	$1,021.01	$1,949.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $430.04 / $514.17 / $2,066.69	Professional		$430.04	$514.17	$2,066.69
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 $488.97 / $959.40 / $2,797.75	Professional		$488.97	$959.40	$2,797.75
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 $1,394.03 / $1,629.04 / $2,498.98	Facility		$1,394.03	$1,629.04	$2,498.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $652.96 / $1,550.92 / $2,376.27	Professional		$652.96	$1,550.92	$2,376.27
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $479.70 / $633.91 / $1,090.06	Facility		$479.70	$633.91	$1,090.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $486.28 / $723.36 / $1,449.00	Facility		$486.28	$723.36	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $543.38 / $1,179.77 / $3,923.12	Professional		$543.38	$1,179.77	$3,923.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.42 / $236.10 / $1,044.18	Professional		$58.42	$236.10	$1,044.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $486.28 / $623.99 / $1,090.06	Facility		$486.28	$623.99	$1,090.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,053.65 / $1,283.83 / $1,852.48	Professional		$1,053.65	$1,283.83	$1,852.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $2,916.50	Facility		$264.92	$264.92	$2,916.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $960.75 / $2,294.19 / $3,923.12	Professional		$960.75	$2,294.19	$3,923.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,573.37 / $1,573.37 / $1,687.43	Professional		$1,573.37	$1,573.37	$1,687.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,521.52 / $3,141.52 / $3,369.13	Professional		$1,521.52	$3,141.52	$3,369.13
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 $531.96 / $977.27 / $2,229.50	Professional		$531.96	$977.27	$2,229.50