Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $608.58 / $1,288.06 / $14,482.00	Facility		$608.58	$1,288.06	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $582.08 / $636.90 / $2,831.15	Professional		$582.08	$636.90	$2,831.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $8,139.00 / $11,136.00	Facility		$5,060.00	$8,139.00	$11,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $593.14 / $1,404.42 / $3,569.43	Professional		$593.14	$1,404.42	$3,569.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,462.54 / $3,462.54 / $3,462.54	Facility		$3,462.54	$3,462.54	$3,462.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,630.13 / $1,904.93 / $2,922.21	Facility		$1,630.13	$1,904.93	$2,922.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $922.55 / $2,492.98 / $2,832.94	Professional		$922.55	$2,492.98	$2,832.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $608.58 / $858.71 / $1,300.81	Facility		$608.58	$858.71	$1,300.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $608.58 / $1,230.81 / $11,100.00	Facility		$608.58	$1,230.81	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $651.52 / $1,192.95 / $4,648.39	Professional		$651.52	$1,192.95	$4,648.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $360.37 / $1,146.06	Professional		$65.66	$360.37	$1,146.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $608.58 / $852.01 / $1,300.81	Facility		$608.58	$852.01	$1,300.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,249.30 / $1,522.22 / $2,272.38	Professional		$1,249.30	$1,522.22	$2,272.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,244.77 / $3,244.77 / $8,957.00	Facility		$3,244.77	$3,244.77	$8,957.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,166.36 / $2,961.45 / $4,648.39	Professional		$1,166.36	$2,961.45	$4,648.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,007.30 / $2,007.30 / $2,007.30	Professional		$2,007.30	$2,007.30	$2,007.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,463.73 / $3,076.87 / $3,967.50	Professional		$1,463.73	$3,076.87	$3,967.50
United Facility/Professional Facility Modifier Low / Median / High Price $4,240.00 / $9,158.00 / $12,062.00	Facility		$4,240.00	$9,158.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $646.73 / $1,184.64 / $2,694.92	Professional		$646.73	$1,184.64	$2,694.92