Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $778.14 / $1,663.54 / $14,482.00	Facility		$778.14	$1,663.54	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $768.90 / $801.50 / $3,885.28	Professional		$768.90	$801.50	$3,885.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $10,038.00	Facility		$2,740.00	$4,780.00	$10,038.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $853.25 / $1,795.70 / $4,978.53	Professional		$853.25	$1,795.70	$4,978.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,669.32 / $2,669.32 / $2,669.32	Facility		$2,669.32	$2,669.32	$2,669.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,068.07 / $2,416.69 / $3,707.29	Facility		$2,068.07	$2,416.69	$3,707.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,240.80 / $3,180.34 / $3,614.03	Professional		$1,240.80	$3,180.34	$3,614.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $768.90 / $1,167.21 / $1,783.70	Facility		$768.90	$1,167.21	$1,783.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $778.14 / $1,633.83 / $13,120.00	Facility		$778.14	$1,633.83	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $962.63 / $1,780.22 / $6,294.01	Professional		$962.63	$1,780.22	$6,294.01
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 $768.90 / $1,167.21 / $1,783.70	Facility		$768.90	$1,167.21	$1,783.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,567.80 / $1,910.30 / $2,851.71	Professional		$1,567.80	$1,910.30	$2,851.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,865.24 / $2,865.24 / $7,909.30	Facility		$2,865.24	$2,865.24	$7,909.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,487.95 / $4,064.10 / $6,294.01	Professional		$1,487.95	$4,064.10	$6,294.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,576.85 / $2,576.85 / $2,576.85	Professional		$2,576.85	$2,576.85	$2,576.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,847.43 / $4,537.01 / $5,061.34	Professional		$1,847.43	$4,537.01	$5,061.34
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 $903.26 / $1,780.08 / $3,698.33	Professional		$903.26	$1,780.08	$3,698.33