Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $264.27 / $564.57 / $6,461.00	Facility		$264.27	$564.57	$6,461.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.59 / $393.65 / $1,253.03	Professional		$254.59	$393.65	$1,253.03
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 $334.78 / $609.85 / $1,737.24	Professional		$334.78	$609.85	$1,737.24
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 $1,099.36 / $1,284.70 / $1,970.76	Facility		$1,099.36	$1,284.70	$1,970.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $464.86 / $999.90 / $1,886.75	Professional		$464.86	$999.90	$1,886.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $264.27 / $426.11 / $843.86	Facility		$264.27	$426.11	$843.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $272.89 / $535.48 / $7,160.00	Facility		$272.89	$535.48	$7,160.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $443.99 / $920.41 / $3,047.68	Professional		$443.99	$920.41	$3,047.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $235.40 / $764.87	Professional		$52.59	$235.40	$764.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $264.27 / $426.11 / $843.86	Facility		$264.27	$426.11	$843.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $623.80 / $928.92 / $1,370.40	Professional		$623.80	$928.92	$1,370.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,271.11 / $1,271.11 / $3,244.77	Facility		$1,271.11	$1,271.11	$3,244.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $570.86 / $1,747.80 / $3,047.68	Professional		$570.86	$1,747.80	$3,047.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $841.33 / $1,740.76 / $2,642.33	Professional		$841.33	$1,740.76	$2,642.33
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 $432.35 / $829.48 / $1,861.27	Professional		$432.35	$829.48	$1,861.27