Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $612.03 / $1,295.01 / $14,482.00	Facility		$612.03	$1,295.01	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $585.52 / $640.45 / $2,847.54	Professional		$585.52	$640.45	$2,847.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,692.00 / $13,743.77 / $21,606.00	Facility		$5,692.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $593.96 / $1,412.38 / $3,749.68	Professional		$593.96	$1,412.38	$3,749.68
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 $1,639.14 / $1,915.46 / $2,938.37	Facility		$1,639.14	$1,915.46	$2,938.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $927.59 / $2,506.11 / $2,847.85	Professional		$927.59	$2,506.11	$2,847.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $612.03 / $880.77 / $1,320.29	Facility		$612.03	$880.77	$1,320.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $612.03 / $1,235.56 / $8,384.00	Facility		$612.03	$1,235.56	$8,384.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $681.84 / $1,199.64 / $4,673.04	Professional		$681.84	$1,199.64	$4,673.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $297.02 / $1,189.88	Professional		$62.75	$297.02	$1,189.88
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $612.03 / $880.77 / $1,320.29	Facility		$612.03	$880.77	$1,320.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,256.45 / $1,530.94 / $2,285.39	Professional		$1,256.45	$1,530.94	$2,285.39
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 $1,172.49 / $2,978.60 / $4,673.04	Professional		$1,172.49	$2,978.60	$4,673.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,017.80 / $2,017.80 / $2,017.80	Professional		$2,017.80	$2,017.80	$2,017.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,563.21 / $3,093.56 / $3,988.32	Professional		$1,563.21	$3,093.56	$3,988.32
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $667.06 / $1,191.11 / $2,710.53	Professional		$667.06	$1,191.11	$2,710.53