Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $296.91 / $1,738.10 / $5,191.89	Facility		$296.91	$1,738.10	$5,191.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.68 / $205.18 / $1,055.77	Professional		$106.68	$205.18	$1,055.77
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 $148.46 / $296.98 / $964.74	Professional		$148.46	$296.98	$964.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.98 / $151.31 / $151.31	Facility		$100.98	$151.31	$151.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $208.61 / $286.48 / $322.43	Professional		$208.61	$286.48	$322.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $410.01 / $479.13 / $772.82	Facility		$410.01	$479.13	$772.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.78 / $346.54 / $588.90	Professional		$212.78	$346.54	$588.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $108.80 / $186.68 / $314.93	Facility		$108.80	$186.68	$314.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $129.56 / $606.54 / $4,195.00	Facility		$129.56	$606.54	$4,195.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $201.11 / $474.24 / $1,044.24	Professional		$201.11	$474.24	$1,044.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.30 / $224.60 / $370.99	Professional		$77.30	$224.60	$370.99
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $108.80 / $186.68 / $314.93	Facility		$108.80	$186.68	$314.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $245.02 / $353.26 / $571.04	Professional		$245.02	$353.26	$571.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $625.29 / $625.29 / $625.29	Facility		$625.29	$625.29	$625.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $202.08 / $656.82 / $1,733.60	Professional		$202.08	$656.82	$1,733.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $492.15 / $722.53 / $1,043.70	Professional		$492.15	$722.53	$1,043.70
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $182.48 / $396.19 / $851.28	Professional		$182.48	$396.19	$851.28