Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $337.43 / $721.73 / $1,894.00	Facility		$337.43	$721.73	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $337.43 / $385.95 / $1,523.80	Professional		$337.43	$385.95	$1,523.80
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 $354.92 / $674.85 / $2,044.51	Professional		$354.92	$674.85	$2,044.51
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 $1,031.78 / $1,205.72 / $1,849.60	Facility		$1,031.78	$1,205.72	$1,849.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $438.62 / $1,147.58 / $1,701.00	Professional		$438.62	$1,147.58	$1,701.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $337.43 / $446.18 / $806.72	Facility		$337.43	$446.18	$806.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $337.43 / $542.54 / $4,792.00	Facility		$337.43	$542.54	$4,792.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $376.12 / $807.34 / $2,876.08	Professional		$376.12	$807.34	$2,876.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $224.24 / $763.47	Professional		$52.59	$224.24	$763.47
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $337.43 / $441.80 / $806.72	Facility		$337.43	$441.80	$806.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $765.61 / $941.69 / $1,350.23	Professional		$765.61	$941.69	$1,350.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,640.84 / $1,640.84 / $3,244.77	Facility		$1,640.84	$1,640.84	$3,244.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $696.82 / $1,640.79 / $2,876.08	Professional		$696.82	$1,640.79	$2,876.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,103.17 / $1,103.17 / $1,235.10	Professional		$1,103.17	$1,103.17	$1,235.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,036.15 / $2,216.16 / $2,480.56	Professional		$1,036.15	$2,216.16	$2,480.56
United Facility/Professional Facility Modifier Low / Median / High Price $2,723.00 / $3,912.00 / $5,865.00	Facility		$2,723.00	$3,912.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $383.99 / $690.00 / $1,580.55	Professional		$383.99	$690.00	$1,580.55