Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.26 / $291.02 / $6,461.00	Facility		$138.26	$291.02	$6,461.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.26 / $349.06 / $1,099.28	Professional		$138.26	$349.06	$1,099.28
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 $206.06 / $438.18 / $1,295.18	Professional		$206.06	$438.18	$1,295.18
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 $657.82 / $768.71 / $1,179.22	Facility		$657.82	$768.71	$1,179.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.66 / $565.39 / $1,133.08	Professional		$271.66	$565.39	$1,133.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $138.26 / $293.11 / $638.01	Facility		$138.26	$293.11	$638.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $155.21 / $392.50 / $6,669.00	Facility		$155.21	$392.50	$6,669.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $492.95 / $976.88 / $2,614.80	Professional		$492.95	$976.88	$2,614.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $135.61 / $383.61 / $596.55	Professional		$135.61	$383.61	$596.55
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $138.26 / $305.55 / $638.01	Facility		$138.26	$305.55	$638.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $321.10 / $531.66 / $861.90	Professional		$321.10	$531.66	$861.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $875.91 / $875.91 / $1,722.47	Facility		$875.91	$875.91	$1,722.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $408.18 / $1,562.95 / $2,614.80	Professional		$408.18	$1,562.95	$2,614.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $433.68 / $1,329.07 / $1,589.87	Professional		$433.68	$1,329.07	$1,589.87
United Facility/Professional Facility Modifier Low / Median / High Price $4,103.00 / $6,477.00 / $8,384.00	Facility		$4,103.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $367.50 / $867.26 / $1,975.47	Professional		$367.50	$867.26	$1,975.47