Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $789.82 / $1,686.60 / $14,482.00	Facility		$789.82	$1,686.60	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $781.08 / $812.52 / $3,939.72	Professional		$781.08	$812.52	$3,939.72
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 $864.43 / $1,822.66 / $5,124.87	Professional		$864.43	$1,822.66	$5,124.87
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 $2,098.71 / $2,452.51 / $3,762.21	Facility		$2,098.71	$2,452.51	$3,762.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,257.70 / $3,226.81 / $3,666.83	Professional		$1,257.70	$3,226.81	$3,666.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $781.08 / $1,184.73 / $1,874.00	Facility		$781.08	$1,184.73	$1,874.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $789.82 / $1,656.55 / $13,250.00	Facility		$789.82	$1,656.55	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $974.13 / $1,809.39 / $8,584.09	Professional		$974.13	$1,809.39	$8,584.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $472.74 / $1,501.51	Professional		$66.47	$472.74	$1,501.51
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $781.08 / $1,184.73 / $1,874.00	Facility		$781.08	$1,184.73	$1,874.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,589.25 / $1,936.44 / $2,890.72	Professional		$1,589.25	$1,936.44	$2,890.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,653.04 / $7,653.04 / $21,125.75	Facility		$7,653.04	$7,653.04	$21,125.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,509.68 / $4,121.05 / $8,584.09	Professional		$1,509.68	$4,121.05	$8,584.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,616.40 / $2,616.40 / $2,616.40	Professional		$2,616.40	$2,616.40	$2,616.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,060.60 / $4,596.06 / $5,135.27	Professional		$2,060.60	$4,596.06	$5,135.27
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 $913.25 / $1,805.02 / $3,762.52	Professional		$913.25	$1,805.02	$3,762.52