Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.88 / $334.60 / $1,894.00	Facility		$157.88	$334.60	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $157.88 / $250.30 / $848.19	Professional		$157.88	$250.30	$848.19
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 $200.02 / $364.37 / $928.26	Professional		$200.02	$364.37	$928.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $463.64 / $463.64 / $463.64	Facility		$463.64	$463.64	$463.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $682.15 / $797.14 / $1,222.83	Facility		$682.15	$797.14	$1,222.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $268.19 / $617.92 / $1,111.55	Professional		$268.19	$617.92	$1,111.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $157.88 / $255.04 / $520.55	Facility		$157.88	$255.04	$520.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $159.69 / $319.70 / $3,034.00	Facility		$159.69	$319.70	$3,034.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $270.06 / $552.40 / $1,889.60	Professional		$270.06	$552.40	$1,889.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $180.36 / $499.03	Professional		$28.95	$180.36	$499.03
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $157.88 / $255.04 / $520.55	Facility		$157.88	$255.04	$520.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $375.25 / $569.50 / $853.27	Professional		$375.25	$569.50	$853.27
Quartz Facility/Professional Facility Modifier Low / Median / High Price $334.99 / $334.99 / $763.48	Facility		$334.99	$334.99	$763.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $339.75 / $1,082.39 / $1,889.60	Professional		$339.75	$1,082.39	$1,889.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $532.16 / $1,036.02 / $1,636.33	Professional		$532.16	$1,036.02	$1,636.33
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,391.00	Facility		$2,367.00	$3,088.30	$4,391.00
United Facility/Professional Professional Modifier Low / Median / High Price $260.57 / $491.02 / $1,114.89	Professional		$260.57	$491.02	$1,114.89