Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $624.92 / $1,321.22 / $14,482.00	Facility		$624.92	$1,321.22	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $598.41 / $659.31 / $2,495.64	Professional		$598.41	$659.31	$2,495.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,139.00 / $15,055.00 / $22,609.00	Facility		$8,139.00	$15,055.00	$22,609.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $610.03 / $1,268.19 / $3,834.32	Professional		$610.03	$1,268.19	$3,834.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14,551.22 / $14,551.22 / $14,551.22	Facility		$14,551.22	$14,551.22	$14,551.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,670.68 / $1,952.32 / $2,994.91	Facility		$1,670.68	$1,952.32	$2,994.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $944.74 / $2,557.37 / $2,906.10	Professional		$944.74	$2,557.37	$2,906.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $624.92 / $907.23 / $1,365.00	Facility		$624.92	$907.23	$1,365.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $624.92 / $1,281.95 / $13,250.00	Facility		$624.92	$1,281.95	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $699.52 / $1,228.67 / $4,773.12	Professional		$699.52	$1,228.67	$4,773.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $381.78 / $1,224.20	Professional		$65.66	$381.78	$1,224.20
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $624.92 / $904.93 / $1,365.00	Facility		$624.92	$904.93	$1,365.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,283.09 / $1,563.41 / $2,333.86	Professional		$1,283.09	$1,563.41	$2,333.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $19,155.48 / $19,155.48 / $52,877.55	Facility		$19,155.48	$19,155.48	$52,877.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,196.49 / $3,049.30 / $4,773.12	Professional		$1,196.49	$3,049.30	$4,773.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,063.32 / $2,063.32 / $2,063.32	Professional		$2,063.32	$2,063.32	$2,063.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,563.21 / $3,165.59 / $4,069.93	Professional		$1,563.21	$3,165.59	$4,069.93
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 $696.32 / $1,282.75 / $2,774.86	Professional		$696.32	$1,282.75	$2,774.86