Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $757.51 / $1,599.12 / $14,482.00	Facility		$757.51	$1,599.12	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $726.49 / $790.80 / $3,553.60	Professional		$726.49	$790.80	$3,553.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,287.00 / $13,743.77 / $21,606.00	Facility		$9,287.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $741.98 / $1,697.57 / $4,918.10	Professional		$741.98	$1,697.57	$4,918.10
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 $2,020.31 / $2,360.89 / $3,621.67	Facility		$2,020.31	$2,360.89	$3,621.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,141.96 / $3,096.60 / $3,518.86	Professional		$1,141.96	$3,096.60	$3,518.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $757.51 / $1,060.51 / $1,674.10	Facility		$757.51	$1,060.51	$1,674.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $757.51 / $1,570.00 / $11,598.00	Facility		$757.51	$1,570.00	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $840.47 / $1,501.55 / $5,787.52	Professional		$840.47	$1,501.55	$5,787.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $462.45 / $1,522.33	Professional		$66.47	$462.45	$1,522.33
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $757.51 / $1,040.76 / $1,674.10	Facility		$757.51	$1,040.76	$1,674.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,555.45 / $1,895.26 / $2,829.24	Professional		$1,555.45	$1,895.26	$2,829.24
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 $1,448.77 / $3,717.15 / $5,787.52	Professional		$1,448.77	$3,717.15	$5,787.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,501.65 / $2,501.65 / $2,501.65	Professional		$2,501.65	$2,501.65	$2,501.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,383.04 / $3,842.53 / $4,928.06	Professional		$2,383.04	$3,842.53	$4,928.06
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 $840.47 / $1,672.72 / $3,567.20	Professional		$840.47	$1,672.72	$3,567.20