Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $261.52 / $855.63 / $1,894.00	Facility		$261.52	$855.63	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.50 / $400.27 / $1,232.57	Professional		$242.50	$400.27	$1,232.57
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 $331.30 / $603.51 / $1,604.70	Professional		$331.30	$603.51	$1,604.70
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 $1,111.98 / $1,299.44 / $1,993.37	Facility		$1,111.98	$1,299.44	$1,993.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $449.42 / $1,036.59 / $1,906.23	Professional		$449.42	$1,036.59	$1,906.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $261.52 / $418.92 / $855.63	Facility		$261.52	$418.92	$855.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $261.52 / $508.33 / $7,160.00	Facility		$261.52	$508.33	$7,160.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $434.88 / $920.07 / $3,078.96	Professional		$434.88	$920.07	$3,078.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $219.68 / $785.24	Professional		$31.53	$219.68	$785.24
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $261.52 / $418.92 / $855.63	Facility		$261.52	$418.92	$855.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $620.08 / $925.53 / $1,390.64	Professional		$620.08	$925.53	$1,390.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,260.32 / $1,260.32 / $3,244.77	Facility		$1,260.32	$1,260.32	$3,244.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $564.89 / $1,765.85 / $3,078.96	Professional		$564.89	$1,765.85	$3,078.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $835.00 / $1,722.57 / $2,669.65	Professional		$835.00	$1,722.57	$2,669.65
United Facility/Professional Facility Modifier Low / Median / High Price $4,614.00 / $7,495.00 / $9,134.00	Facility		$4,614.00	$7,495.00	$9,134.00
United Facility/Professional Professional Modifier Low / Median / High Price $434.88 / $792.12 / $1,868.28	Professional		$434.88	$792.12	$1,868.28