Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $696.90 / $854.25 / $3,283.19	Facility		$696.90	$854.25	$3,283.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $696.90 / $854.25 / $3,516.60	Professional		$696.90	$854.25	$3,516.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $888.58 / $1,608.22 / $4,595.04	Professional		$888.58	$1,608.22	$4,595.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,186.38 / $1,186.38 / $1,186.38	Facility		$1,186.38	$1,186.38	$1,186.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,279.83 / $2,664.17 / $4,086.90	Facility		$2,279.83	$2,664.17	$4,086.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,099.82 / $2,580.32 / $3,974.28	Professional		$1,099.82	$2,580.32	$3,974.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $696.90 / $1,093.57 / $1,842.19	Facility		$696.90	$1,093.57	$1,842.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $735.25 / $1,293.52 / $4,292.39	Facility		$735.25	$1,293.52	$4,292.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,046.24 / $2,030.49 / $6,495.04	Professional		$1,046.24	$2,030.49	$6,495.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $702.59 / $1,860.19	Professional		$62.75	$702.59	$1,860.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $696.90 / $1,078.10 / $1,842.19	Facility		$696.90	$1,078.10	$1,842.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,562.16 / $2,117.02 / $3,035.46	Professional		$1,562.16	$2,117.02	$3,035.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $796.23 / $796.23 / $3,269.82	Facility		$796.23	$796.23	$3,269.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,506.20 / $3,681.59 / $6,495.04	Professional		$1,506.20	$3,681.59	$6,495.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,314.79 / $2,314.79 / $2,822.51	Professional		$2,314.79	$2,314.79	$2,822.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,750.08 / $4,508.26 / $5,565.86	Professional		$2,750.08	$4,508.26	$5,565.86
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $947.65 / $1,797.21 / $4,025.25	Professional		$947.65	$1,797.21	$4,025.25