Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $249.61 / $532.13 / $3,119.00	Facility		$249.61	$532.13	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.86 / $380.19 / $1,005.13	Professional		$242.86	$380.19	$1,005.13
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 $316.20 / $576.03 / $1,466.01	Professional		$316.20	$576.03	$1,466.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $709.83 / $709.83 / $709.83	Facility		$709.83	$709.83	$709.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,030.88 / $1,204.67 / $1,847.99	Facility		$1,030.88	$1,204.67	$1,847.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $424.44 / $937.20 / $1,771.38	Professional		$424.44	$937.20	$1,771.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $242.86 / $380.19 / $791.91	Facility		$242.86	$380.19	$791.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $246.40 / $491.25 / $6,669.00	Facility		$246.40	$491.25	$6,669.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $409.28 / $867.38 / $2,862.88	Professional		$409.28	$867.38	$2,862.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $227.13 / $710.88	Professional		$52.59	$227.13	$710.88
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $242.86 / $380.19 / $791.91	Facility		$242.86	$380.19	$791.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $584.15 / $868.72 / $1,280.46	Professional		$584.15	$868.72	$1,280.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $476.54 / $476.54 / $1,196.00	Facility		$476.54	$476.54	$1,196.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $538.49 / $1,640.93 / $2,862.88	Professional		$538.49	$1,640.93	$2,862.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $792.98 / $1,642.07 / $2,480.77	Professional		$792.98	$1,642.07	$2,480.77
United Facility/Professional Facility Modifier Low / Median / High Price $4,103.00 / $7,495.00 / $9,134.00	Facility		$4,103.00	$7,495.00	$9,134.00
United Facility/Professional Professional Modifier Low / Median / High Price $406.01 / $771.00 / $1,759.81	Professional		$406.01	$771.00	$1,759.81