Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $617.40 / $1,306.09 / $14,482.00	Facility		$617.40	$1,306.09	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $590.92 / $645.78 / $2,877.70	Professional		$590.92	$645.78	$2,877.70
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 $602.57 / $1,416.54 / $3,622.85	Professional		$602.57	$1,416.54	$3,622.85
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 $1,652.65 / $1,931.26 / $2,962.60	Facility		$1,652.65	$1,931.26	$2,962.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $934.65 / $2,527.79 / $2,872.49	Professional		$934.65	$2,527.79	$2,872.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $617.40 / $873.66 / $1,364.45	Facility		$617.40	$873.66	$1,364.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $617.40 / $1,267.89 / $11,100.00	Facility		$617.40	$1,267.89	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $684.96 / $1,210.08 / $4,715.43	Professional		$684.96	$1,210.08	$4,715.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $371.43 / $1,187.41	Professional		$65.66	$371.43	$1,187.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $617.40 / $873.66 / $1,364.45	Facility		$617.40	$873.66	$1,364.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,267.50 / $1,544.40 / $2,305.48	Professional		$1,267.50	$1,544.40	$2,305.48
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 $1,182.65 / $3,010.15 / $4,715.43	Professional		$1,182.65	$3,010.15	$4,715.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,037.35 / $2,037.35 / $2,037.35	Professional		$2,037.35	$2,037.35	$2,037.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,915.99 / $3,124.91 / $4,022.83	Professional		$1,915.99	$3,124.91	$4,022.83
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 $657.91 / $1,204.06 / $2,757.30	Professional		$657.91	$1,204.06	$2,757.30