Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $859.75 / $1,795.36 / $14,482.00	Facility		$859.75	$1,795.36	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $816.05 / $859.75 / $4,113.76	Professional		$816.05	$859.75	$4,113.76
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 $868.22 / $1,903.27 / $5,279.21	Professional		$868.22	$1,903.27	$5,279.21
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 $2,282.54 / $2,667.33 / $4,091.74	Facility		$2,282.54	$2,667.33	$4,091.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,207.61 / $3,484.88 / $3,960.09	Professional		$1,207.61	$3,484.88	$3,960.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $847.93 / $1,215.51 / $1,994.85	Facility		$847.93	$1,215.51	$1,994.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $859.75 / $1,795.37 / $13,250.00	Facility		$859.75	$1,795.37	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $930.52 / $1,729.85 / $7,988.04	Professional		$930.52	$1,729.85	$7,988.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $504.92 / $1,603.82	Professional		$66.47	$504.92	$1,603.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $847.93 / $1,203.65 / $1,994.85	Facility		$847.93	$1,203.65	$1,994.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,692.60 / $2,062.37 / $3,078.71	Professional		$1,692.60	$2,062.37	$3,078.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,994.41 / $5,994.41 / $16,547.20	Facility		$5,994.41	$5,994.41	$16,547.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,630.42 / $4,303.10 / $7,988.04	Professional		$1,630.42	$4,303.10	$7,988.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,853.18 / $2,853.18 / $2,853.18	Professional		$2,853.18	$2,853.18	$2,853.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,629.04 / $4,410.68 / $5,545.94	Professional		$2,629.04	$4,410.68	$5,545.94
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 $909.82 / $1,721.62 / $3,915.82	Professional		$909.82	$1,721.62	$3,915.82