Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $266.57 / $572.78 / $3,119.00	Facility		$266.57	$572.78	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.78 / $402.17 / $1,064.90	Professional		$252.78	$402.17	$1,064.90
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 $337.70 / $615.16 / $1,676.58	Professional		$337.70	$615.16	$1,676.58
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 $1,106.58 / $1,293.11 / $1,983.68	Facility		$1,106.58	$1,293.11	$1,983.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $448.23 / $1,010.82 / $1,894.66	Professional		$448.23	$1,010.82	$1,894.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $260.61 / $405.85 / $850.68	Facility		$260.61	$405.85	$850.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $262.38 / $483.94 / $6,669.00	Facility		$262.38	$483.94	$6,669.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $427.37 / $906.93 / $3,056.56	Professional		$427.37	$906.93	$3,056.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $238.55 / $767.85	Professional		$52.59	$238.55	$767.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $262.38 / $405.85 / $850.68	Facility		$262.38	$405.85	$850.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $632.96 / $937.36 / $1,381.64	Professional		$632.96	$937.36	$1,381.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,286.24 / $1,286.24 / $1,722.47	Facility		$1,286.24	$1,286.24	$1,722.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $577.35 / $1,755.14 / $3,056.56	Professional		$577.35	$1,755.14	$3,056.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $853.57 / $1,760.54 / $2,653.46	Professional		$853.57	$1,760.54	$2,653.46
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 $411.98 / $807.09 / $1,834.01	Professional		$411.98	$807.09	$1,834.01