Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $720.70 / $1,515.29 / $14,482.00	Facility		$720.70	$1,515.29	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $689.79 / $752.84 / $2,862.21	Professional		$689.79	$752.84	$2,862.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,479.00 / $9,096.00 / $15,579.70	Facility		$5,479.00	$9,096.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $711.96 / $1,663.15 / $4,655.60	Professional		$711.96	$1,663.15	$4,655.60
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 $1,913.08 / $2,235.58 / $3,429.44	Facility		$1,913.08	$2,235.58	$3,429.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,081.40 / $2,931.34 / $3,331.06	Professional		$1,081.40	$2,931.34	$3,331.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $720.70 / $1,008.98 / $1,592.75	Facility		$720.70	$1,008.98	$1,592.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $720.70 / $1,464.24 / $8,384.00	Facility		$720.70	$1,464.24	$8,384.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $782.62 / $1,433.46 / $6,323.73	Professional		$782.62	$1,433.46	$6,323.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $421.51 / $1,367.95	Professional		$66.47	$421.51	$1,367.95
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $720.70 / $1,006.33 / $1,592.75	Facility		$720.70	$1,006.33	$1,592.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,464.45 / $1,784.38 / $2,663.72	Professional		$1,464.45	$1,784.38	$2,663.72
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 $1,371.45 / $3,564.15 / $6,323.73	Professional		$1,371.45	$3,564.15	$6,323.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,379.90 / $2,379.90 / $2,379.90	Professional		$2,379.90	$2,379.90	$2,379.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,163.05 / $3,650.54 / $4,665.05	Professional		$2,163.05	$3,650.54	$4,665.05
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 $775.73 / $1,454.17 / $3,332.51	Professional		$775.73	$1,454.17	$3,332.51