Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.61 / $586.94 / $6,511.11	Facility		$132.61	$586.94	$6,511.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.61 / $314.44 / $1,215.50	Professional		$132.61	$314.44	$1,215.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.83 / $582.29 / $1,424.06	Professional		$230.83	$582.29	$1,424.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $125.25 / $188.96 / $188.96	Facility		$125.25	$188.96	$188.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $268.45 / $378.42 / $584.92	Professional		$268.45	$378.42	$584.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $816.41 / $954.05 / $1,538.84	Facility		$816.41	$954.05	$1,538.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.76 / $468.03 / $1,091.35	Professional		$217.76	$468.03	$1,091.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $132.61 / $286.95 / $560.85	Facility		$132.61	$286.95	$560.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.27 / $425.01 / $8,103.00	Facility		$139.27	$425.01	$8,103.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $304.75 / $907.00 / $1,793.45	Professional		$304.75	$907.00	$1,793.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $374.30 / $676.07	Professional		$85.00	$374.30	$676.07
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $132.61 / $269.17 / $560.85	Facility		$132.61	$269.17	$560.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $303.79 / $548.15 / $1,006.14	Professional		$303.79	$548.15	$1,006.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,021.77 / $1,021.77 / $1,021.77	Facility		$1,021.77	$1,021.77	$1,021.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $201.89 / $1,239.00 / $3,439.23	Professional		$201.89	$1,239.00	$3,439.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $634.76 / $778.78 / $1,816.01	Professional		$634.76	$778.78	$1,816.01
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $293.77 / $836.30 / $1,565.33	Professional		$293.77	$836.30	$1,565.33