Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $668.35 / $1,389.85 / $14,482.00	Facility		$668.35	$1,389.85	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $667.26 / $692.21 / $3,027.80	Professional		$667.26	$692.21	$3,027.80
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 $640.04 / $1,542.33 / $4,219.38	Professional		$640.04	$1,542.33	$4,219.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8,646.40 / $8,646.40 / $8,646.40	Facility		$8,646.40	$8,646.40	$8,646.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,787.82 / $2,089.21 / $3,204.90	Facility		$1,787.82	$2,089.21	$3,204.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,051.25 / $2,707.45 / $3,076.65	Professional		$1,051.25	$2,707.45	$3,076.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $667.26 / $896.06 / $1,477.05	Facility		$667.26	$896.06	$1,477.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $667.26 / $1,289.07 / $8,384.00	Facility		$667.26	$1,289.07	$8,384.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $744.32 / $1,401.35 / $5,007.80	Professional		$744.32	$1,401.35	$5,007.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $396.24 / $1,263.86	Professional		$66.47	$396.24	$1,263.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $667.26 / $832.16 / $1,477.05	Facility		$667.26	$832.16	$1,477.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,319.50 / $1,607.76 / $2,400.07	Professional		$1,319.50	$1,607.76	$2,400.07
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 $1,266.69 / $3,167.15 / $5,007.80	Professional		$1,266.69	$3,167.15	$5,007.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,218.90 / $2,218.90 / $2,218.90	Professional		$2,218.90	$2,218.90	$2,218.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,071.17 / $3,765.44 / $4,308.74	Professional		$2,071.17	$3,765.44	$4,308.74
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 $676.32 / $1,364.63 / $2,882.11	Professional		$676.32	$1,364.63	$2,882.11