Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $825.05 / $1,739.20 / $14,482.00	Facility		$825.05	$1,739.20	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $791.95 / $859.61 / $3,877.87	Professional		$791.95	$859.61	$3,877.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $12,444.00	Facility		$5,169.00	$8,408.00	$12,444.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $811.69 / $1,903.97 / $4,849.66	Professional		$811.69	$1,903.97	$4,849.66
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 $2,196.03 / $2,566.23 / $3,936.67	Facility		$2,196.03	$2,566.23	$3,936.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,241.33 / $3,369.67 / $3,829.18	Professional		$1,241.33	$3,369.67	$3,829.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $825.05 / $1,180.19 / $1,823.36	Facility		$825.05	$1,180.19	$1,823.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $825.05 / $1,710.26 / $11,100.00	Facility		$825.05	$1,710.26	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $926.88 / $1,640.85 / $6,303.36	Professional		$926.88	$1,640.85	$6,303.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $501.24 / $1,593.92	Professional		$66.47	$501.24	$1,593.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $825.05 / $1,180.19 / $1,823.36	Facility		$825.05	$1,180.19	$1,823.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,691.95 / $2,061.58 / $3,077.53	Professional		$1,691.95	$2,061.58	$3,077.53
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 $1,576.53 / $4,056.35 / $6,303.36	Professional		$1,576.53	$4,056.35	$6,303.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,727.28 / $2,727.28 / $2,727.28	Professional		$2,727.28	$2,727.28	$2,727.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,932.70 / $4,190.71 / $5,362.67	Professional		$1,932.70	$4,190.71	$5,362.67
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 $888.17 / $1,573.86 / $3,622.48	Professional		$888.17	$1,573.86	$3,622.48