Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.81 / $634.50 / $1,894.00	Facility		$117.81	$634.50	$1,894.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.38 / $212.44 / $724.96	Professional		$59.38	$212.44	$724.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $1,183.00 / $1,530.00	Facility		$1,139.00	$1,183.00	$1,530.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.33 / $256.47 / $945.47	Professional		$86.33	$256.47	$945.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.29 / $71.09 / $90.77	Facility		$52.29	$71.09	$90.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.68 / $270.75 / $551.91	Professional		$218.68	$270.75	$551.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $659.62 / $770.82 / $1,024.48	Facility		$659.62	$770.82	$1,024.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.08 / $217.94 / $825.60	Professional		$84.08	$217.94	$825.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.40 / $146.69 / $319.35	Facility		$57.40	$146.69	$319.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.55 / $241.13 / $1,449.00	Facility		$61.55	$241.13	$1,449.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.58 / $635.98 / $2,881.04	Professional		$199.58	$635.98	$2,881.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $130.84 / $218.08 / $520.69	Professional		$130.84	$218.08	$520.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.47 / $146.69 / $319.35	Facility		$57.47	$146.69	$319.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $133.47 / $262.50 / $767.80	Professional		$133.47	$262.50	$767.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $147.66 / $336.80 / $1,300.00	Facility		$147.66	$336.80	$1,300.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $114.66 / $1,033.29 / $2,881.04	Professional		$114.66	$1,033.29	$2,881.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $152.76 / $308.95 / $1,327.21	Professional		$152.76	$308.95	$1,327.21
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,533.00 / $2,202.90	Facility		$1,034.00	$1,533.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $208.03 / $465.65 / $825.22	Professional		$208.03	$465.65	$825.22