Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $270.26 / $579.49 / $1,894.00	Facility		$270.26	$579.49	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $270.26 / $309.76 / $1,252.48	Professional		$270.26	$309.76	$1,252.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $277.91 / $540.50 / $1,599.75	Professional		$277.91	$540.50	$1,599.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,462.54 / $3,462.54 / $3,462.54	Facility		$3,462.54	$3,462.54	$3,462.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $848.86 / $991.95 / $1,521.68	Facility		$848.86	$991.95	$1,521.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $419.66 / $994.19 / $1,454.65	Professional		$419.66	$994.19	$1,454.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $270.26 / $362.42 / $663.77	Facility		$270.26	$362.42	$663.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $270.26 / $444.20 / $7,318.00	Facility		$270.26	$444.20	$7,318.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $294.70 / $652.41 / $2,356.80	Professional		$294.70	$652.41	$2,356.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $147.84 / $691.33	Professional		$31.53	$147.84	$691.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $270.26 / $362.42 / $663.77	Facility		$270.26	$362.42	$663.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $610.98 / $772.20 / $1,107.21	Professional		$610.98	$772.20	$1,107.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,315.04 / $1,315.04 / $3,244.77	Facility		$1,315.04	$1,315.04	$3,244.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $558.13 / $1,347.53 / $2,356.80	Professional		$558.13	$1,347.53	$2,356.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $881.59 / $881.59 / $1,011.30	Professional		$881.59	$881.59	$1,011.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $847.11 / $1,779.28 / $2,037.18	Professional		$847.11	$1,779.28	$2,037.18
United Facility/Professional Facility Modifier Low / Median / High Price $4,103.00 / $6,477.00 / $8,384.00	Facility		$4,103.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $294.70 / $562.52 / $1,319.32	Professional		$294.70	$562.52	$1,319.32