Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.57 / $768.35 / $8,243.00	Facility		$363.57	$768.35	$8,243.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $345.87 / $503.41 / $1,874.15	Professional		$345.87	$503.41	$1,874.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $460.58 / $839.00 / $2,139.11	Professional		$460.58	$839.00	$2,139.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,507.48 / $1,507.48 / $1,507.48	Facility		$1,507.48	$1,507.48	$1,507.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,394.93 / $1,630.09 / $2,500.60	Facility		$1,394.93	$1,630.09	$2,500.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $597.60 / $1,347.13 / $2,404.00	Professional		$597.60	$1,347.13	$2,404.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $363.57 / $587.70 / $1,078.29	Facility		$363.57	$587.70	$1,078.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $375.73 / $718.86 / $3,034.00	Facility		$375.73	$718.86	$3,034.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $579.02 / $1,174.43 / $3,894.72	Professional		$579.02	$1,174.43	$3,894.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $302.11 / $992.62	Professional		$61.84	$302.11	$992.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $363.57 / $583.79 / $1,078.29	Facility		$363.57	$583.79	$1,078.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $839.70 / $1,199.36 / $1,748.13	Professional		$839.70	$1,199.36	$1,748.13
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,455.33 / $1,455.33 / $1,733.72	Facility		$1,455.33	$1,455.33	$1,733.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $779.29 / $2,226.96 / $3,894.72	Professional		$779.29	$2,226.96	$3,894.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,145.02 / $2,376.34 / $3,366.78	Professional		$1,145.02	$2,376.34	$3,366.78
United Facility/Professional Facility Modifier Low / Median / High Price $1,957.00 / $3,068.00 / $4,295.00	Facility		$1,957.00	$3,068.00	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $554.14 / $1,051.00 / $2,374.96	Professional		$554.14	$1,051.00	$2,374.96