Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $325.91 / $697.07 / $3,119.00	Facility		$325.91	$697.07	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.68 / $369.43 / $1,489.03	Professional		$309.68	$369.43	$1,489.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $3,483.00 / $5,962.00	Facility		$1,183.00	$3,483.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $349.60 / $713.54 / $1,896.63	Professional		$349.60	$713.54	$1,896.63
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 $1,007.45 / $1,177.29 / $1,805.99	Facility		$1,007.45	$1,177.29	$1,805.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $430.72 / $988.07 / $1,731.89	Professional		$430.72	$988.07	$1,731.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $325.91 / $447.96 / $788.31	Facility		$325.91	$447.96	$788.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $337.13 / $492.04 / $4,292.39	Facility		$337.13	$492.04	$4,292.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $359.54 / $786.08 / $2,814.64	Professional		$359.54	$786.08	$2,814.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $224.24 / $759.22	Professional		$52.59	$224.24	$759.22
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $325.91 / $433.92 / $788.31	Facility		$325.91	$433.92	$788.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $740.72 / $921.10 / $1,320.70	Professional		$740.72	$921.10	$1,320.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,587.16 / $1,587.16 / $1,722.47	Facility		$1,587.16	$1,587.16	$1,722.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $671.76 / $1,604.34 / $2,814.64	Professional		$671.76	$1,604.34	$2,814.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,066.59 / $1,066.59 / $1,207.50	Professional		$1,066.59	$1,066.59	$1,207.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $933.77 / $2,141.54 / $2,425.44	Professional		$933.77	$2,141.54	$2,425.44
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $360.39 / $677.78 / $1,541.29	Professional		$360.39	$677.78	$1,541.29