Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.23 / $575.64 / $6,461.00	Facility		$269.23	$575.64	$6,461.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.84 / $418.21 / $1,260.92	Professional		$255.84	$418.21	$1,260.92
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 $341.06 / $621.29 / $1,690.82	Professional		$341.06	$621.29	$1,690.82
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 $1,139.02 / $1,331.03 / $2,041.83	Facility		$1,139.02	$1,331.03	$2,041.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.17 / $1,036.20 / $1,952.14	Professional		$456.17	$1,036.20	$1,952.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $269.23 / $418.21 / $873.37	Facility		$269.23	$418.21	$873.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $274.47 / $536.51 / $6,955.00	Facility		$274.47	$536.51	$6,955.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $451.16 / $937.22 / $3,151.36	Professional		$451.16	$937.22	$3,151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $250.69 / $787.27	Professional		$52.59	$250.69	$787.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $269.23 / $418.21 / $873.37	Facility		$269.23	$418.21	$873.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $636.77 / $948.23 / $1,418.74	Professional		$636.77	$948.23	$1,418.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,298.40 / $1,298.40 / $1,722.47	Facility		$1,298.40	$1,298.40	$1,722.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $582.41 / $1,808.37 / $3,151.36	Professional		$582.41	$1,808.37	$3,151.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $857.83 / $1,775.96 / $2,733.89	Professional		$857.83	$1,775.96	$2,733.89
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $442.25 / $845.50 / $1,907.75	Professional		$442.25	$845.50	$1,907.75