Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.58 / $641.66 / $3,119.00	Facility		$302.58	$641.66	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.88 / $446.56 / $1,612.32	Professional		$297.88	$446.56	$1,612.32
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 $383.33 / $698.29 / $1,776.38	Professional		$383.33	$698.29	$1,776.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $796.22 / $796.22 / $796.22	Facility		$796.22	$796.22	$796.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,211.10 / $1,415.27 / $2,171.06	Facility		$1,211.10	$1,415.27	$2,171.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $499.06 / $1,124.79 / $2,082.23	Professional		$499.06	$1,124.79	$2,082.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $302.58 / $494.14 / $926.51	Facility		$302.58	$494.14	$926.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $309.94 / $603.46 / $6,669.00	Facility		$309.94	$603.46	$6,669.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $474.09 / $999.50 / $3,369.12	Professional		$474.09	$999.50	$3,369.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $255.86 / $853.17	Professional		$52.59	$255.86	$853.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $302.58 / $494.14 / $926.51	Facility		$302.58	$494.14	$926.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $709.98 / $1,022.82 / $1,506.43	Professional		$709.98	$1,022.82	$1,506.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $548.99 / $548.99 / $1,452.88	Facility		$548.99	$548.99	$1,452.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $652.11 / $1,928.88 / $3,369.12	Professional		$652.11	$1,928.88	$3,369.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $956.21 / $1,988.49 / $2,916.06	Professional		$956.21	$1,988.49	$2,916.06
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 $474.09 / $889.63 / $2,021.20	Professional		$474.09	$889.63	$2,021.20