Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $887.71 / $1,866.24 / $14,482.00	Facility		$887.71	$1,866.24	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $850.10 / $918.64 / $4,217.49	Professional		$850.10	$918.64	$4,217.49
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 $882.67 / $2,048.56 / $5,735.37	Professional		$882.67	$2,048.56	$5,735.37
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 $2,355.53 / $2,752.62 / $4,222.59	Facility		$2,355.53	$2,752.62	$4,222.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,332.62 / $3,611.20 / $4,103.64	Professional		$1,332.62	$3,611.20	$4,103.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $887.71 / $1,253.60 / $2,073.60	Facility		$887.71	$1,253.60	$2,073.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $887.71 / $1,838.41 / $13,250.00	Facility		$887.71	$1,838.41	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $972.79 / $1,780.28 / $8,385.95	Professional		$972.79	$1,780.28	$8,385.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $549.66 / $1,756.75	Professional		$66.47	$549.66	$1,756.75
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $887.71 / $1,244.16 / $2,073.60	Facility		$887.71	$1,244.16	$2,073.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,804.40 / $2,198.59 / $3,282.06	Professional		$1,804.40	$2,198.59	$3,282.06
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 $1,689.52 / $4,411.60 / $8,385.95	Professional		$1,689.52	$4,411.60	$8,385.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,934.25 / $2,934.25 / $2,934.25	Professional		$2,934.25	$2,934.25	$2,934.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,984.89 / $4,507.18 / $5,746.99	Professional		$2,984.89	$4,507.18	$5,746.99
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 $962.35 / $1,764.64 / $4,041.03	Professional		$962.35	$1,764.64	$4,041.03