Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $401.18 / $854.19 / $1,894.00	Facility		$401.18	$854.19	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $395.47 / $437.67 / $1,613.47	Professional		$395.47	$437.67	$1,613.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $412.87 / $802.56 / $2,327.67	Professional		$412.87	$802.56	$2,327.67
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 $1,189.48 / $1,390.00 / $2,132.30	Facility		$1,189.48	$1,390.00	$2,132.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $545.09 / $1,259.59 / $2,049.59	Professional		$545.09	$1,259.59	$2,049.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $373.89 / $504.36 / $949.10	Facility		$373.89	$504.36	$949.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $374.23 / $620.07 / $3,034.00	Facility		$374.23	$620.07	$3,034.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $461.34 / $950.26 / $3,337.28	Professional		$461.34	$950.26	$3,337.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $276.50 / $914.37	Professional		$52.59	$276.50	$914.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $373.89 / $496.06 / $949.10	Facility		$373.89	$496.06	$949.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $892.45 / $1,087.42 / $1,559.18	Professional		$892.45	$1,087.42	$1,559.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $1,951.12	Facility		$1,722.47	$1,722.47	$1,951.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $818.52 / $1,905.75 / $3,337.28	Professional		$818.52	$1,905.75	$3,337.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,271.57 / $2,631.95 / $2,870.35	Professional		$1,271.57	$2,631.95	$2,870.35
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $448.59 / $818.10 / $1,883.79	Professional		$448.59	$818.10	$1,883.79