Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.25 / $329.54 / $1,057.76	Facility		$154.25	$329.54	$1,057.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.25 / $270.77 / $834.00	Professional		$154.25	$270.77	$834.00
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 $195.41 / $355.97 / $942.17	Professional		$195.41	$355.97	$942.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $334.36 / $334.36 / $334.36	Facility		$334.36	$334.36	$334.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $755.14 / $882.44 / $1,353.68	Facility		$755.14	$882.44	$1,353.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.07 / $634.29 / $1,233.00	Professional		$257.07	$634.29	$1,233.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $158.47 / $280.00 / $574.03	Facility		$158.47	$280.00	$574.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $163.32 / $320.60 / $1,449.00	Facility		$163.32	$320.60	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $270.80 / $575.62 / $2,085.84	Professional		$270.80	$575.62	$2,085.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $152.87 / $270.61 / $626.72	Professional		$152.87	$270.61	$626.72
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $158.47 / $280.00 / $574.03	Facility		$158.47	$280.00	$574.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $375.25 / $599.66 / $979.18	Professional		$375.25	$599.66	$979.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $292.86 / $292.86 / $751.52	Facility		$292.86	$292.86	$751.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $331.04 / $1,195.25 / $2,085.84	Professional		$331.04	$1,195.25	$2,085.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $505.36 / $505.36 / $871.06	Professional		$505.36	$505.36	$871.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $606.69 / $1,009.46 / $1,807.01	Professional		$606.69	$1,009.46	$1,807.01
United Facility/Professional Facility Modifier Low / Median / High Price $785.00 / $1,297.00 / $2,202.90	Facility		$785.00	$1,297.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $265.22 / $511.66 / $1,164.03	Professional		$265.22	$511.66	$1,164.03