Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $717.27 / $1,514.25 / $14,482.00	Facility		$717.27	$1,514.25	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $679.26 / $758.37 / $2,860.25	Professional		$679.26	$758.37	$2,860.25
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 $700.76 / $1,655.25 / $4,398.89	Professional		$700.76	$1,655.25	$4,398.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11,605.06 / $11,605.06 / $11,605.06	Facility		$11,605.06	$11,605.06	$11,605.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,914.88 / $2,237.69 / $3,432.67	Facility		$1,914.88	$2,237.69	$3,432.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,081.94 / $2,932.95 / $3,332.90	Professional		$1,081.94	$2,932.95	$3,332.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $717.27 / $1,009.50 / $1,540.33	Facility		$717.27	$1,009.50	$1,540.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $717.27 / $1,460.80 / $11,598.00	Facility		$717.27	$1,460.80	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $770.86 / $1,418.27 / $5,479.12	Professional		$770.86	$1,418.27	$5,479.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $421.51 / $1,392.12	Professional		$66.47	$421.51	$1,392.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $717.27 / $1,004.18 / $1,540.33	Facility		$717.27	$1,004.18	$1,540.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,471.60 / $1,793.09 / $2,676.73	Professional		$1,471.60	$1,793.09	$2,676.73
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 $1,372.21 / $3,512.10 / $5,479.12	Professional		$1,372.21	$3,512.10	$5,479.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,367.14 / $2,367.14 / $2,367.14	Professional		$2,367.14	$2,367.14	$2,367.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,918.49 / $3,634.47 / $4,667.68	Professional		$1,918.49	$3,634.47	$4,667.68
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $766.02 / $1,400.42 / $3,217.08	Professional		$766.02	$1,400.42	$3,217.08