Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $262.58 / $492.57 / $1,894.00	Facility		$262.58	$492.57	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.36 / $295.06 / $1,198.86	Professional		$248.36	$295.06	$1,198.86
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 $282.45 / $605.96 / $1,593.36	Professional		$282.45	$605.96	$1,593.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $463.64 / $463.64 / $463.64	Facility		$463.64	$463.64	$463.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $701.07 / $819.26 / $1,256.76	Facility		$701.07	$819.26	$1,256.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $370.13 / $828.09 / $1,210.45	Professional		$370.13	$828.09	$1,210.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $260.30 / $345.22 / $580.29	Facility		$260.30	$345.22	$580.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $262.58 / $422.00 / $1,455.00	Facility		$262.58	$422.00	$1,455.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $308.66 / $631.35 / $1,970.27	Professional		$308.66	$631.35	$1,970.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $185.44 / $488.92	Professional		$62.75	$185.44	$488.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $260.30 / $345.22 / $580.29	Facility		$260.30	$345.22	$580.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $513.50 / $632.16 / $934.02	Professional		$513.50	$632.16	$934.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $293.11 / $293.11 / $1,103.92	Facility		$293.11	$293.11	$1,103.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $483.41 / $1,254.05 / $1,970.27	Professional		$483.41	$1,254.05	$1,970.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $854.63 / $854.63 / $960.87	Professional		$854.63	$854.63	$960.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $846.30 / $1,517.51 / $1,695.18	Professional		$846.30	$1,517.51	$1,695.18
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $298.45 / $581.07 / $1,346.40	Professional		$298.45	$581.07	$1,346.40