Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.55 / $364.52 / $3,119.00	Facility		$170.55	$364.52	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.55 / $269.66 / $925.33	Professional		$170.55	$269.66	$925.33
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 $216.06 / $393.59 / $1,042.59	Professional		$216.06	$393.59	$1,042.59
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 $746.13 / $871.91 / $1,337.53	Facility		$746.13	$871.91	$1,337.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.54 / $698.78 / $1,279.29	Professional		$284.54	$698.78	$1,279.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $172.70 / $276.39 / $571.67	Facility		$172.70	$276.39	$571.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $179.41 / $339.71 / $1,449.00	Facility		$179.41	$339.71	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $285.04 / $630.27 / $2,073.12	Professional		$285.04	$630.27	$2,073.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $152.87 / $270.61 / $631.07	Professional		$152.87	$270.61	$631.07
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $175.13 / $276.39 / $571.67	Facility		$175.13	$276.39	$571.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $415.67 / $631.57 / $973.56	Professional		$415.67	$631.57	$973.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $292.86 / $292.86 / $830.64	Facility		$292.86	$292.86	$830.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $365.79 / $1,185.08 / $2,073.12	Professional		$365.79	$1,185.08	$2,073.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $559.22 / $559.22 / $871.23	Professional		$559.22	$559.22	$871.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $543.22 / $1,115.41 / $1,791.59	Professional		$543.22	$1,115.41	$1,791.59
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 $282.33 / $527.92 / $1,171.70	Professional		$282.33	$527.92	$1,171.70