Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $343.23 / $989.78 / $4,581.10	Facility		$343.23	$989.78	$4,581.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.18 / $443.62 / $1,455.57	Professional		$231.18	$443.62	$1,455.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,193.00 / $5,962.00	Facility		$1,905.00	$3,193.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.08 / $502.92 / $1,404.79	Professional		$276.08	$502.92	$1,404.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $213.70 / $267.13 / $324.80	Facility		$213.70	$267.13	$324.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $439.72 / $554.53 / $997.88	Professional		$439.72	$554.53	$997.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,301.22 / $1,520.58 / $2,332.60	Facility		$1,301.22	$1,520.58	$2,332.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $350.45 / $803.99 / $2,017.44	Professional		$350.45	$803.99	$2,017.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $235.56 / $471.03 / $903.01	Facility		$235.56	$471.03	$903.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $239.85 / $496.42 / $3,014.84	Facility		$239.85	$496.42	$3,014.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $492.73 / $1,582.31 / $3,602.00	Professional		$492.73	$1,582.31	$3,602.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $753.78 / $1,221.09	Professional		$85.00	$753.78	$1,221.09
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $238.96 / $471.03 / $903.01	Facility		$238.96	$471.03	$903.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $505.38 / $938.60 / $1,639.81	Professional		$505.38	$938.60	$1,639.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $384.52 / $1,310.90 / $3,590.15	Facility		$384.52	$1,310.90	$3,590.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $427.69 / $1,906.00 / $3,602.00	Professional		$427.69	$1,906.00	$3,602.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $819.88 / $1,936.40 / $2,157.61	Professional		$819.88	$1,936.40	$2,157.61
United Facility/Professional Facility Modifier Low / Median / High Price $2,976.00 / $3,827.00 / $5,471.00	Facility		$2,976.00	$3,827.00	$5,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $469.43 / $961.46 / $2,067.67	Professional		$469.43	$961.46	$2,067.67