Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $265.02 / $265.02 / $17,823.00	Facility		$265.02	$265.02	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $265.02 / $433.90 / $679.68	Professional		$265.02	$433.90	$679.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $18,175.43 / $28,720.00	Facility		$12,080.00	$18,175.43	$28,720.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $408.94 / $1,027.24 / $2,889.84	Professional		$408.94	$1,027.24	$2,889.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,159.74 / $1,355.25 / $2,185.96	Facility		$1,159.74	$1,355.25	$2,185.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $503.28 / $620.54 / $800.06	Professional		$503.28	$620.54	$800.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $265.02 / $454.11 / $887.58	Facility		$265.02	$454.11	$887.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $454.11 / $3,364.00 / $7,868.00	Facility		$454.11	$3,364.00	$7,868.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $495.40 / $1,356.19 / $2,320.86	Professional		$495.40	$1,356.19	$2,320.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $1,562.46	Professional		$50.00	$58.40	$1,562.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $265.02 / $454.11 / $887.58	Facility		$265.02	$454.11	$887.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $568.63 / $1,043.58 / $1,455.30	Professional		$568.63	$1,043.58	$1,455.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,002.76 / $2,002.76 / $2,002.76	Facility		$2,002.76	$2,002.76	$2,002.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,809.59 / $3,217.44 / $3,217.44	Professional		$1,809.59	$3,217.44	$3,217.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,239.79 / $2,239.79 / $2,239.79	Professional		$2,239.79	$2,239.79	$2,239.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,716.24 / $3,112.74 / $3,112.74	Professional		$2,716.24	$3,112.74	$3,112.74
United Facility/Professional Facility Modifier Low / Median / High Price $2,203.00 / $4,316.80 / $19,003.00	Facility		$2,203.00	$4,316.80	$19,003.00
United Facility/Professional Professional Modifier Low / Median / High Price $491.23 / $1,413.02 / $2,112.83	Professional		$491.23	$1,413.02	$2,112.83