Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $965.74 / $2,036.14 / $14,482.00	Facility		$965.74	$2,036.14	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $896.72 / $1,006.71 / $4,015.70	Professional		$896.72	$1,006.71	$4,015.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $12,444.00	Facility		$5,169.00	$8,408.00	$12,444.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $959.76 / $2,228.62 / $5,681.60	Professional		$959.76	$2,228.62	$5,681.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,462.54 / $3,462.54 / $3,462.54	Facility		$3,462.54	$3,462.54	$3,462.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,564.59 / $2,996.92 / $4,597.35	Facility		$2,564.59	$2,996.92	$4,597.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,450.15 / $3,942.96 / $4,480.64	Professional		$1,450.15	$3,942.96	$4,480.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $965.74 / $1,273.91 / $2,100.00	Facility		$965.74	$1,273.91	$2,100.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $965.74 / $1,999.59 / $13,120.00	Facility		$965.74	$1,999.59	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,048.76 / $2,093.90 / $7,387.20	Professional		$1,048.76	$2,093.90	$7,387.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $608.25 / $1,930.00	Professional		$66.47	$608.25	$1,930.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $965.74 / $1,267.17 / $2,100.00	Facility		$965.74	$1,267.17	$2,100.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,985.10 / $2,418.77 / $3,610.74	Professional		$1,985.10	$2,418.77	$3,610.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,244.77 / $3,244.77 / $8,957.00	Facility		$3,244.77	$3,244.77	$8,957.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,844.74 / $4,780.60 / $7,387.20	Professional		$1,844.74	$4,780.60	$7,387.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,195.11 / $3,195.11 / $3,195.11	Professional		$3,195.11	$3,195.11	$3,195.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,842.20 / $4,915.63 / $6,274.96	Professional		$2,842.20	$4,915.63	$6,274.96
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,048.76 / $1,912.24 / $4,692.39	Professional		$1,048.76	$1,912.24	$4,692.39