Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $795.08 / $2,989.70 / $17,546.20	Facility		$795.08	$2,989.70	$17,546.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $762.90 / $829.43 / $3,733.75	Professional		$762.90	$829.43	$3,733.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,287.00 / $13,743.77 / $21,606.00	Facility		$9,287.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $783.18 / $1,834.80 / $4,882.82	Professional		$783.18	$1,834.80	$4,882.82
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 $2,117.63 / $2,474.62 / $3,796.13	Facility		$2,117.63	$2,474.62	$3,796.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,208.75 / $3,248.99 / $3,692.04	Professional		$1,208.75	$3,248.99	$3,692.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $795.08 / $1,051.90 / $1,757.13	Facility		$795.08	$1,051.90	$1,757.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $795.08 / $1,602.95 / $13,250.00	Facility		$795.08	$1,602.95	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $898.09 / $1,620.74 / $6,075.12	Professional		$898.09	$1,620.74	$6,075.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $490.51 / $1,575.17	Professional		$66.47	$490.51	$1,575.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $795.08 / $1,051.90 / $1,757.13	Facility		$795.08	$1,051.90	$1,757.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,632.15 / $1,988.71 / $2,968.76	Professional		$1,632.15	$1,988.71	$2,968.76
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 $1,520.06 / $3,905.60 / $6,075.12	Professional		$1,520.06	$3,905.60	$6,075.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,627.55 / $2,627.55 / $2,627.55	Professional		$2,627.55	$2,627.55	$2,627.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,421.10 / $4,036.31 / $5,170.60	Professional		$1,421.10	$4,036.31	$5,170.60
United Facility/Professional Facility Modifier Low / Median / High Price $4,981.00 / $11,799.00 / $16,373.00	Facility		$4,981.00	$11,799.00	$16,373.00
United Facility/Professional Professional Modifier Low / Median / High Price $882.83 / $1,657.06 / $3,744.71	Professional		$882.83	$1,657.06	$3,744.71