Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $631.11 / $1,324.51 / $13,367.00	Facility		$631.11	$1,324.51	$13,367.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $631.11 / $796.83 / $3,134.67	Professional		$631.11	$796.83	$3,134.67
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 $747.18 / $1,456.40 / $3,870.40	Professional		$747.18	$1,456.40	$3,870.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,554.79 / $1,554.79 / $1,554.79	Facility		$1,554.79	$1,554.79	$1,554.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,141.06 / $2,502.00 / $3,838.13	Facility		$2,141.06	$2,502.00	$3,838.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $916.82 / $2,326.37 / $3,584.82	Professional		$916.82	$2,326.37	$3,584.82
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $633.74 / $946.67 / $1,659.53	Facility		$633.74	$946.67	$1,659.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $646.98 / $1,158.95 / $4,292.39	Facility		$646.98	$1,158.95	$4,292.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $859.57 / $1,731.82 / $6,724.95	Professional		$859.57	$1,731.82	$6,724.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $475.17 / $1,535.48	Professional		$66.47	$475.17	$1,535.48
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $641.86 / $946.67 / $1,659.53	Facility		$641.86	$946.67	$1,659.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,424.87 / $1,914.42 / $2,728.43	Professional		$1,424.87	$1,914.42	$2,728.43
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,350.75 / $1,350.75 / $4,541.82	Facility		$1,350.75	$1,350.75	$4,541.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,330.91 / $3,422.34 / $6,724.95	Professional		$1,330.91	$3,422.34	$6,724.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,075.98 / $2,075.98 / $2,625.08	Professional		$2,075.98	$2,075.98	$2,625.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,973.81 / $4,105.47 / $5,173.93	Professional		$1,973.81	$4,105.47	$5,173.93
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $807.32 / $1,563.28 / $3,455.79	Professional		$807.32	$1,563.28	$3,455.79