Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $762.13 / $1,609.38 / $14,482.00	Facility		$762.13	$1,609.38	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $730.93 / $795.75 / $3,577.83	Professional		$730.93	$795.75	$3,577.83
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 $744.44 / $1,758.77 / $4,680.39	Professional		$744.44	$1,758.77	$4,680.39
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 $2,032.93 / $2,375.64 / $3,644.29	Facility		$2,032.93	$2,375.64	$3,644.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,166.79 / $3,115.83 / $3,540.71	Professional		$1,166.79	$3,115.83	$3,540.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $762.13 / $1,104.46 / $1,684.31	Facility		$762.13	$1,104.46	$1,684.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $762.13 / $1,547.87 / $13,250.00	Facility		$762.13	$1,547.87	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $860.19 / $1,511.75 / $5,823.92	Professional		$860.19	$1,511.75	$5,823.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $479.17 / $1,525.19	Professional		$66.47	$479.17	$1,525.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $762.13 / $1,101.86 / $1,684.31	Facility		$762.13	$1,101.86	$1,684.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,565.20 / $1,907.14 / $2,846.98	Professional		$1,565.20	$1,907.14	$2,846.98
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 $1,457.75 / $3,742.50 / $5,823.92	Professional		$1,457.75	$3,742.50	$5,823.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,518.63 / $2,518.63 / $2,518.63	Professional		$2,518.63	$2,518.63	$2,518.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,032.17 / $3,868.10 / $4,958.63	Professional		$2,032.17	$3,868.10	$4,958.63
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $842.62 / $1,639.22 / $3,405.68	Professional		$842.62	$1,639.22	$3,405.68