Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $775.59 / $1,637.42 / $14,482.00	Facility		$775.59	$1,637.42	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $743.16 / $809.72 / $3,622.33	Professional		$743.16	$809.72	$3,622.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,139.00 / $13,743.77 / $21,606.00	Facility		$8,139.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $755.55 / $1,789.83 / $4,758.97	Professional		$755.55	$1,789.83	$4,758.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,560.77 / $7,560.77 / $7,560.77	Facility		$7,560.77	$7,560.77	$7,560.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,069.87 / $2,418.81 / $3,710.52	Facility		$2,069.87	$2,418.81	$3,710.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,170.21 / $3,170.17 / $3,602.46	Professional		$1,170.21	$3,170.17	$3,602.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $775.59 / $1,091.60 / $1,691.52	Facility		$775.59	$1,091.60	$1,691.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $775.59 / $1,581.59 / $11,598.00	Facility		$775.59	$1,581.59	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $865.86 / $1,571.22 / $5,920.16	Professional		$865.86	$1,571.22	$5,920.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $469.00 / $1,525.19	Professional		$66.47	$469.00	$1,525.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $775.59 / $1,086.44 / $1,691.52	Facility		$775.59	$1,086.44	$1,691.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,591.20 / $1,938.82 / $2,894.27	Professional		$1,591.20	$1,938.82	$2,894.27
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,213.88 / $7,213.88 / $19,913.50	Facility		$7,213.88	$7,213.88	$19,913.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,483.17 / $3,789.05 / $5,920.16	Professional		$1,483.17	$3,789.05	$5,920.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,560.92 / $2,560.92 / $2,560.92	Professional		$2,560.92	$2,560.92	$2,560.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,131.65 / $3,927.11 / $5,045.08	Professional		$2,131.65	$3,927.11	$5,045.08
United Facility/Professional Facility Modifier Low / Median / High Price $4,240.00 / $9,837.00 / $12,631.00	Facility		$4,240.00	$9,837.00	$12,631.00
United Facility/Professional Professional Modifier Low / Median / High Price $833.59 / $1,515.70 / $3,448.04	Professional		$833.59	$1,515.70	$3,448.04