Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $730.34 / $1,537.45 / $14,482.00	Facility		$730.34	$1,537.45	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $698.62 / $757.06 / $3,456.08	Professional		$698.62	$757.06	$3,456.08
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 $723.28 / $1,676.82 / $4,496.28	Professional		$723.28	$1,676.82	$4,496.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,669.32 / $2,669.32 / $2,669.32	Facility		$2,669.32	$2,669.32	$2,669.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,941.91 / $2,269.28 / $3,481.13	Facility		$1,941.91	$2,269.28	$3,481.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,095.72 / $2,974.20 / $3,379.78	Professional		$1,095.72	$2,974.20	$3,379.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $730.34 / $1,022.48 / $1,708.28	Facility		$730.34	$1,022.48	$1,708.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $730.34 / $1,515.73 / $8,292.34	Facility		$730.34	$1,515.73	$8,292.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $795.33 / $1,453.29 / $6,723.29	Professional		$795.33	$1,453.29	$6,723.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $432.10 / $1,392.88	Professional		$66.47	$432.10	$1,392.88
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $730.34 / $1,012.59 / $1,708.28	Facility		$730.34	$1,012.59	$1,708.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,485.25 / $1,809.72 / $2,701.56	Professional		$1,485.25	$1,809.72	$2,701.56
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,865.24 / $2,865.24 / $7,909.30	Facility		$2,865.24	$2,865.24	$7,909.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,391.50 / $3,615.15 / $6,723.29	Professional		$1,391.50	$3,615.15	$6,723.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,411.69 / $2,411.69 / $2,411.69	Professional		$2,411.69	$2,411.69	$2,411.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,261.52 / $3,701.88 / $4,733.24	Professional		$2,261.52	$3,701.88	$4,733.24
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $784.95 / $1,402.68 / $3,289.79	Professional		$784.95	$1,402.68	$3,289.79