Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $176.94 / $381.24 / $1,894.00	Facility		$176.94	$381.24	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.93 / $191.07 / $800.40	Professional		$165.93	$191.07	$800.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.86 / $408.32 / $1,031.03	Professional		$191.86	$408.32	$1,031.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $319.44 / $319.44 / $319.44	Facility		$319.44	$319.44	$319.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $542.47 / $633.91 / $972.46	Facility		$542.47	$633.91	$972.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.89 / $675.12 / $934.24	Professional		$274.89	$675.12	$934.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $171.95 / $240.75 / $423.60	Facility		$171.95	$240.75	$423.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $175.55 / $283.81 / $1,449.00	Facility		$175.55	$283.81	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $211.07 / $437.74 / $1,511.12	Professional		$211.07	$437.74	$1,511.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $153.19 / $429.02	Professional		$28.95	$153.19	$429.02
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $171.95 / $240.75 / $423.60	Facility		$171.95	$240.75	$423.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $390.73 / $482.33 / $698.31	Professional		$390.73	$482.33	$698.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $248.58 / $248.58 / $829.58	Facility		$248.58	$248.58	$829.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $368.27 / $865.44 / $1,511.12	Professional		$368.27	$865.44	$1,511.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $579.79 / $579.79 / $646.90	Professional		$579.79	$579.79	$646.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $568.13 / $1,173.99 / $1,308.36	Professional		$568.13	$1,173.99	$1,308.36
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 $201.02 / $394.47 / $867.78	Professional		$201.02	$394.47	$867.78