Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $796.72 / $1,603.84 / $3,496.44	Facility		$796.72	$1,603.84	$3,496.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $744.03 / $976.51 / $3,705.70	Professional		$744.03	$976.51	$3,705.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $810.31 / $1,593.43 / $4,587.93	Professional		$810.31	$1,593.43	$4,587.93
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 $2,611.44 / $3,051.68 / $4,681.35	Facility		$2,611.44	$3,051.68	$4,681.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $981.66 / $2,825.34 / $4,430.51	Professional		$981.66	$2,825.34	$4,430.51
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $451.71 / $1,025.08 / $1,982.41	Facility		$451.71	$1,025.08	$1,982.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $500.06 / $1,195.08 / $4,292.39	Facility		$500.06	$1,195.08	$4,292.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $724.43 / $1,919.80 / $7,097.28	Professional		$724.43	$1,919.80	$7,097.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.79 / $552.76 / $1,790.84	Professional		$67.79	$552.76	$1,790.84
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $451.71 / $1,016.36 / $1,982.41	Facility		$451.71	$1,016.36	$1,982.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,696.80 / $2,230.73 / $3,070.65	Professional		$1,696.80	$2,230.73	$3,070.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,350.75 / $1,350.75 / $5,529.30	Facility		$1,350.75	$1,350.75	$5,529.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,660.95 / $4,104.22 / $7,097.28	Professional		$1,660.95	$4,104.22	$7,097.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,687.59 / $2,687.59 / $3,294.83	Professional		$2,687.59	$2,687.59	$3,294.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,913.49 / $5,064.85 / $6,204.83	Professional		$1,913.49	$5,064.85	$6,204.83
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 $781.07 / $1,434.53 / $3,949.06	Professional		$781.07	$1,434.53	$3,949.06