Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.41 / $325.70 / $1,894.00	Facility		$152.41	$325.70	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.41 / $244.49 / $824.54	Professional		$152.41	$244.49	$824.54
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 $193.08 / $351.73 / $930.70	Professional		$193.08	$351.73	$930.70
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 $676.74 / $790.83 / $1,213.15	Facility		$676.74	$790.83	$1,213.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.33 / $608.01 / $1,093.99	Professional		$254.33	$608.01	$1,093.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $152.41 / $246.89 / $518.32	Facility		$152.41	$246.89	$518.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $156.61 / $300.50 / $1,449.00	Facility		$156.61	$300.50	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $256.04 / $570.60 / $1,877.68	Professional		$256.04	$570.60	$1,877.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $134.13 / $258.38 / $551.40	Professional		$134.13	$258.38	$551.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $152.41 / $246.89 / $518.32	Facility		$152.41	$246.89	$518.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $370.67 / $571.77 / $881.37	Professional		$370.67	$571.77	$881.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $292.86 / $292.86 / $742.36	Facility		$292.86	$292.86	$742.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $327.14 / $1,074.15 / $1,877.68	Professional		$327.14	$1,074.15	$1,877.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $499.22 / $499.22 / $788.86	Professional		$499.22	$499.22	$788.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $485.38 / $997.56 / $1,623.88	Professional		$485.38	$997.56	$1,623.88
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 $237.84 / $463.60 / $1,054.69	Professional		$237.84	$463.60	$1,054.69