Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $874.50 / $1,843.29 / $14,482.00	Facility		$874.50	$1,843.29	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $839.00 / $911.39 / $4,100.28	Professional		$839.00	$911.39	$4,100.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,139.00 / $13,743.77 / $21,606.00	Facility		$8,139.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $858.23 / $2,018.08 / $5,372.89	Professional		$858.23	$2,018.08	$5,372.89
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 $2,329.40 / $2,722.08 / $4,175.74	Facility		$2,329.40	$2,722.08	$4,175.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,317.32 / $3,572.72 / $4,059.91	Professional		$1,317.32	$3,572.72	$4,059.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $874.50 / $1,287.89 / $2,048.10	Facility		$874.50	$1,287.89	$2,048.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $874.50 / $1,814.11 / $13,250.00	Facility		$874.50	$1,814.11	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $986.38 / $1,730.16 / $7,433.26	Professional		$986.38	$1,730.16	$7,433.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $557.31 / $1,751.19	Professional		$66.47	$557.31	$1,751.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $874.50 / $1,266.55 / $2,048.10	Facility		$874.50	$1,266.55	$2,048.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,793.35 / $2,185.13 / $3,261.97	Professional		$1,793.35	$2,185.13	$3,261.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,305.39 / $10,305.39 / $28,447.40	Facility		$10,305.39	$10,305.39	$28,447.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,671.52 / $4,289.00 / $7,433.26	Professional		$1,671.52	$4,289.00	$7,433.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,891.29 / $2,891.29 / $2,891.29	Professional		$2,891.29	$2,891.29	$2,891.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,889.08 / $4,437.51 / $5,685.78	Professional		$2,889.08	$4,437.51	$5,685.78
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 $939.41 / $1,715.60 / $3,902.99	Professional		$939.41	$1,715.60	$3,902.99