Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $277.44 / $591.21 / $3,119.00	Facility		$277.44	$591.21	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $277.44 / $413.04 / $1,489.82	Professional		$277.44	$413.04	$1,489.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $351.47 / $640.26 / $1,728.15	Professional		$351.47	$640.26	$1,728.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,462.54 / $3,462.54 / $3,462.54	Facility		$3,462.54	$3,462.54	$3,462.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,120.08 / $1,308.92 / $2,007.91	Facility		$1,120.08	$1,308.92	$2,007.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $468.29 / $1,103.58 / $1,926.34	Professional		$468.29	$1,103.58	$1,926.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $277.44 / $483.26 / $860.77	Facility		$277.44	$483.26	$860.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $284.07 / $567.25 / $7,160.00	Facility		$284.07	$567.25	$7,160.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $468.90 / $948.30 / $3,117.91	Professional		$468.90	$948.30	$3,117.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $235.64 / $764.87	Professional		$52.59	$235.64	$764.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $277.44 / $483.26 / $860.77	Facility		$277.44	$483.26	$860.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $649.74 / $948.04 / $1,397.38	Professional		$649.74	$948.04	$1,397.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,328.36 / $1,328.36 / $3,244.77	Facility		$1,328.36	$1,328.36	$3,244.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $598.29 / $1,784.48 / $3,117.91	Professional		$598.29	$1,784.48	$3,117.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $915.59 / $915.59 / $1,376.35	Professional		$915.59	$915.59	$1,376.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,286.88 / $1,824.44 / $2,697.79	Professional		$1,286.88	$1,824.44	$2,697.79
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 $459.29 / $843.05 / $1,899.81	Professional		$459.29	$843.05	$1,899.81