Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $655.60 / $1,386.54 / $14,482.00	Facility		$655.60	$1,386.54	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $627.48 / $685.27 / $3,058.20	Professional		$627.48	$685.27	$3,058.20
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 $640.98 / $1,504.44 / $3,847.63	Professional		$640.98	$1,504.44	$3,847.63
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 $1,754.48 / $2,050.25 / $3,145.14	Facility		$1,754.48	$2,050.25	$3,145.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $995.07 / $2,684.67 / $3,050.76	Professional		$995.07	$2,684.67	$3,050.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $655.60 / $948.03 / $1,530.75	Facility		$655.60	$948.03	$1,530.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $655.60 / $1,348.71 / $13,120.00	Facility		$655.60	$1,348.71	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $706.72 / $1,290.25 / $5,271.98	Professional		$706.72	$1,290.25	$5,271.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $401.29 / $1,306.38	Professional		$66.47	$401.29	$1,306.38
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $655.60 / $924.36 / $1,530.75	Facility		$655.60	$924.36	$1,530.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,344.85 / $1,638.65 / $2,446.17	Professional		$1,344.85	$1,638.65	$2,446.17
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 $1,256.04 / $3,198.95 / $5,271.98	Professional		$1,256.04	$3,198.95	$5,271.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,163.77 / $2,163.77 / $2,163.77	Professional		$2,163.77	$2,163.77	$2,163.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,207.94 / $3,316.01 / $4,272.50	Professional		$1,207.94	$3,316.01	$4,272.50
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 $664.82 / $1,290.25 / $2,911.04	Professional		$664.82	$1,290.25	$2,911.04