Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $304.13 / $653.13 / $1,894.00	Facility		$304.13	$653.13	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $304.13 / $342.30 / $1,383.67	Professional		$304.13	$342.30	$1,383.67
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 $319.60 / $701.84 / $1,850.74	Professional		$319.60	$701.84	$1,850.74
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 $938.97 / $1,097.26 / $1,683.22	Facility		$938.97	$1,097.26	$1,683.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $395.79 / $1,044.51 / $1,608.45	Professional		$395.79	$1,044.51	$1,608.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $304.13 / $400.49 / $732.53	Facility		$304.13	$400.49	$732.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $304.13 / $487.90 / $1,449.00	Facility		$304.13	$487.90	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $325.57 / $721.19 / $2,606.23	Professional		$325.57	$721.19	$2,606.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $214.81 / $681.31	Professional		$52.59	$214.81	$681.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $304.13 / $398.66 / $732.53	Facility		$304.13	$398.66	$732.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $687.17 / $853.78 / $1,224.18	Professional		$687.17	$853.78	$1,224.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $264.92 / $264.92 / $1,480.36	Facility		$264.92	$264.92	$1,480.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $628.41 / $1,490.00 / $2,606.23	Professional		$628.41	$1,490.00	$2,606.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $992.67 / $992.67 / $1,117.96	Professional		$992.67	$992.67	$1,117.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $950.34 / $2,003.36 / $2,252.61	Professional		$950.34	$2,003.36	$2,252.61
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 $332.15 / $631.74 / $1,410.33	Professional		$332.15	$631.74	$1,410.33