Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $508.29 / $1,894.00 / $14,482.00	Facility		$508.29	$1,894.00	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $480.10 / $692.89 / $2,728.50	Professional		$480.10	$692.89	$2,728.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $6,787.00 / $10,517.23	Facility		$1,183.00	$6,787.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $499.94 / $1,172.97 / $3,124.76	Professional		$499.94	$1,172.97	$3,124.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,971.90 / $2,971.90 / $2,971.90	Facility		$2,971.90	$2,971.90	$2,971.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,353.48 / $1,581.65 / $2,426.29	Facility		$1,353.48	$1,581.65	$2,426.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $780.48 / $2,072.26 / $2,354.84	Professional		$780.48	$2,072.26	$2,354.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $508.29 / $692.89 / $1,123.32	Facility		$508.29	$692.89	$1,123.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $508.29 / $1,052.75 / $4,195.00	Facility		$508.29	$1,052.75	$4,195.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $573.20 / $1,001.42 / $3,865.44	Professional		$573.20	$1,001.42	$3,865.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.81 / $294.98 / $964.43	Professional		$61.81	$294.98	$964.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $508.29 / $692.89 / $1,123.32	Facility		$508.29	$692.89	$1,123.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,032.84 / $1,258.49 / $1,878.67	Professional		$1,032.84	$1,258.49	$1,878.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,469.60 / $2,469.60 / $6,817.20	Facility		$2,469.60	$2,469.60	$6,817.20
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $646.16 / $646.16 / $646.16	Facility	AS	$646.16	$646.16	$646.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $940.44 / $2,488.35 / $3,865.44	Professional		$940.44	$2,488.35	$3,865.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,515.80 / $2,566.04 / $3,297.89	Professional		$1,515.80	$2,566.04	$3,297.89
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 $569.99 / $948.12 / $2,222.19	Professional		$569.99	$948.12	$2,222.19