Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $653.82 / $1,395.14 / $3,119.00	Facility		$653.82	$1,395.14	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $653.82 / $785.40 / $3,246.58	Professional		$653.82	$785.40	$3,246.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $9,948.00 / $15,579.70	Facility		$6,538.00	$9,948.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $828.27 / $1,508.81 / $4,297.60	Professional		$828.27	$1,508.81	$4,297.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,995.29 / $5,995.29 / $5,995.29	Facility		$5,995.29	$5,995.29	$5,995.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,109.52 / $2,465.14 / $3,781.59	Facility		$2,109.52	$2,465.14	$3,781.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,042.13 / $2,364.53 / $3,476.97	Professional		$1,042.13	$2,364.53	$3,476.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $653.82 / $980.73 / $1,699.93	Facility		$653.82	$980.73	$1,699.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $684.46 / $1,178.09 / $12,202.00	Facility		$684.46	$1,178.09	$12,202.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $949.50 / $1,852.11 / $5,937.36	Professional		$949.50	$1,852.11	$5,937.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $475.67 / $1,529.66	Professional		$66.47	$475.67	$1,529.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $653.82 / $980.73 / $1,699.93	Facility		$653.82	$980.73	$1,699.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,464.85 / $1,922.98 / $2,782.41	Professional		$1,464.85	$1,922.98	$2,782.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,674.24 / $4,674.24 / $5,994.41	Facility		$4,674.24	$4,674.24	$5,994.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,394.96 / $3,396.00 / $5,937.36	Professional		$1,394.96	$3,396.00	$5,937.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,079.06 / $4,253.75 / $5,111.96	Professional		$2,079.06	$4,253.75	$5,111.96
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 $919.64 / $1,681.98 / $3,671.62	Professional		$919.64	$1,681.98	$3,671.62