Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $690.99 / $1,459.48 / $14,482.00	Facility		$690.99	$1,459.48	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $661.98 / $721.58 / $3,230.99	Professional		$661.98	$721.58	$3,230.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $8,139.00 / $11,136.00	Facility		$5,060.00	$8,139.00	$11,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $675.31 / $1,594.60 / $4,054.62	Professional		$675.31	$1,594.60	$4,054.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,462.54 / $3,462.54 / $3,462.54	Facility		$3,462.54	$3,462.54	$3,462.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,845.49 / $2,156.61 / $3,308.29	Facility		$1,845.49	$2,156.61	$3,308.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,043.59 / $2,826.38 / $3,211.80	Professional		$1,043.59	$2,826.38	$3,211.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $690.99 / $1,003.33 / $1,570.00	Facility		$690.99	$1,003.33	$1,570.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $690.99 / $1,438.61 / $11,100.00	Facility		$690.99	$1,438.61	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $772.25 / $1,413.67 / $5,773.90	Professional		$772.25	$1,413.67	$5,773.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $426.97 / $1,392.12	Professional		$66.47	$426.97	$1,392.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $690.99 / $999.76 / $1,570.00	Facility		$690.99	$999.76	$1,570.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,417.65 / $1,727.35 / $2,578.60	Professional		$1,417.65	$1,727.35	$2,578.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,244.77 / $3,244.77 / $8,957.00	Facility		$3,244.77	$3,244.77	$8,957.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,322.34 / $3,379.70 / $5,773.90	Professional		$1,322.34	$3,379.70	$5,773.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,280.17 / $2,280.17 / $2,280.17	Professional		$2,280.17	$2,280.17	$2,280.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,227.96 / $3,499.07 / $4,498.03	Professional		$2,227.96	$3,499.07	$4,498.03
United Facility/Professional Facility Modifier Low / Median / High Price $6,073.00 / $9,882.00 / $12,631.00	Facility		$6,073.00	$9,882.00	$12,631.00
United Facility/Professional Professional Modifier Low / Median / High Price $747.22 / $1,480.31 / $3,075.53	Professional		$747.22	$1,480.31	$3,075.53