Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.27 / $1,734.60 / $5,704.57	Facility		$178.27	$1,734.60	$5,704.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.54 / $304.70 / $1,049.74	Professional		$86.54	$304.70	$1,049.74
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 $127.89 / $424.25 / $1,526.51	Professional		$127.89	$424.25	$1,526.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $102.88 / $123.03	Facility		$81.70	$102.88	$123.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $264.39 / $332.93 / $590.96	Professional		$264.39	$332.93	$590.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $810.11 / $946.67 / $1,452.22	Facility		$810.11	$946.67	$1,452.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.33 / $356.34 / $1,246.13	Professional		$137.33	$356.34	$1,246.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $90.23 / $210.00 / $580.33	Facility		$90.23	$210.00	$580.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.35 / $269.58 / $3,242.00	Facility		$91.35	$269.58	$3,242.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $309.75 / $1,079.82 / $2,242.03	Professional		$309.75	$1,079.82	$2,242.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $354.74 / $756.05	Professional		$85.00	$354.74	$756.05
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $88.24 / $210.00 / $580.33	Facility		$88.24	$210.00	$580.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $193.42 / $408.91 / $998.19	Professional		$193.42	$408.91	$998.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $147.60 / $733.39 / $4,017.35	Facility		$147.60	$733.39	$4,017.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $166.88 / $1,113.39 / $2,242.03	Professional		$166.88	$1,113.39	$2,242.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $325.23 / $435.11 / $1,521.54	Professional		$325.23	$435.11	$1,521.54
United Facility/Professional Facility Modifier Low / Median / High Price $2,781.00 / $3,628.00 / $5,471.00	Facility		$2,781.00	$3,628.00	$5,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $304.00 / $657.99 / $1,570.79	Professional		$304.00	$657.99	$1,570.79