Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $991.82 / $2,089.46 / $14,482.00	Facility		$991.82	$2,089.46	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $952.45 / $1,032.96 / $4,668.34	Professional		$952.45	$1,032.96	$4,668.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $976.73 / $2,288.80 / $6,096.63	Professional		$976.73	$2,288.80	$6,096.63
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 $2,637.58 / $3,082.22 / $4,728.20	Facility		$2,637.58	$3,082.22	$4,728.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,490.00 / $4,050.43 / $4,602.76	Professional		$1,490.00	$4,050.43	$4,602.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $991.82 / $1,468.45 / $2,191.92	Facility		$991.82	$1,468.45	$2,191.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $991.82 / $2,054.30 / $15,090.00	Facility		$991.82	$2,054.30	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,116.82 / $2,005.33 / $7,580.80	Professional		$1,116.82	$2,005.33	$7,580.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $621.76 / $1,988.80	Professional		$66.47	$621.76	$1,988.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $991.82 / $1,437.13 / $2,191.92	Facility		$991.82	$1,437.13	$2,191.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,034.50 / $2,478.96 / $3,700.60	Professional		$2,034.50	$2,478.96	$3,700.60
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 $1,895.01 / $4,883.20 / $7,580.80	Professional		$1,895.01	$4,883.20	$7,580.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,280.73 / $3,280.73 / $3,280.73	Professional		$3,280.73	$3,280.73	$3,280.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,842.20 / $5,039.63 / $6,445.99	Professional		$2,842.20	$5,039.63	$6,445.99
United Facility/Professional Facility Modifier Low / Median / High Price $6,154.00 / $11,891.00 / $15,090.00	Facility		$6,154.00	$11,891.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,070.42 / $2,056.41 / $4,691.37	Professional		$1,070.42	$2,056.41	$4,691.37