Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.90 / $400.77 / $1,894.00	Facility		$186.90	$400.77	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.27 / $217.33 / $856.24	Professional		$178.27	$217.33	$856.24
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 $213.32 / $431.30 / $1,132.76	Professional		$213.32	$431.30	$1,132.76
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 $518.14 / $605.49 / $928.84	Facility		$518.14	$605.49	$928.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.60 / $670.91 / $890.76	Professional		$281.60	$670.91	$890.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $178.12 / $251.27 / $471.13	Facility		$178.12	$251.27	$471.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $185.80 / $288.13 / $1,449.00	Facility		$185.80	$288.13	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $223.39 / $471.62 / $1,440.00	Professional		$223.39	$471.62	$1,440.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $180.36 / $482.31	Professional		$31.53	$180.36	$482.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $178.12 / $251.27 / $471.13	Facility		$178.12	$251.27	$471.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $413.36 / $542.52 / $770.08	Professional		$413.36	$542.52	$770.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $884.05	Facility		$264.92	$264.92	$884.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $350.81 / $895.65 / $1,440.00	Professional		$350.81	$895.65	$1,440.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $607.59 / $607.59 / $713.84	Professional		$607.59	$607.59	$713.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $597.24 / $1,069.77 / $1,247.44	Professional		$597.24	$1,069.77	$1,247.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,008.00 / $1,370.00 / $2,202.90	Facility		$1,008.00	$1,370.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $220.25 / $431.40 / $1,005.77	Professional		$220.25	$431.40	$1,005.77