Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $820.04 / $1,719.56 / $14,482.00	Facility		$820.04	$1,719.56	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $784.87 / $846.21 / $3,875.19	Professional		$784.87	$846.21	$3,875.19
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 $808.21 / $1,892.40 / $5,294.36	Professional		$808.21	$1,892.40	$5,294.36
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 $2,175.30 / $2,542.01 / $3,899.52	Facility		$2,175.30	$2,542.01	$3,899.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,226.58 / $3,333.51 / $3,788.08	Professional		$1,226.58	$3,333.51	$3,788.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $820.04 / $1,131.49 / $1,910.63	Facility		$820.04	$1,131.49	$1,910.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $820.04 / $1,693.66 / $13,250.00	Facility		$820.04	$1,693.66	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $892.46 / $1,629.53 / $14,641.99	Professional		$892.46	$1,629.53	$14,641.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $489.21 / $1,598.95	Professional		$65.66	$489.21	$1,598.95
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $820.04 / $1,131.49 / $1,910.63	Facility		$820.04	$1,131.49	$1,910.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,661.40 / $2,024.35 / $3,021.96	Professional		$1,661.40	$2,024.35	$3,021.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,617.86 / $7,617.86 / $21,028.65	Facility		$7,617.86	$7,617.86	$21,028.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,559.61 / $4,053.55 / $14,641.99	Professional		$1,559.61	$4,053.55	$14,641.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,715.99 / $2,715.99 / $2,715.99	Professional		$2,715.99	$2,715.99	$2,715.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,762.16 / $4,162.35 / $5,305.13	Professional		$1,762.16	$4,162.35	$5,305.13
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $845.93 / $1,622.66 / $3,688.73	Professional		$845.93	$1,622.66	$3,688.73