Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $772.91 / $3,119.00 / $17,823.00	Facility		$772.91	$3,119.00	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $682.00 / $904.16 / $3,781.37	Professional		$682.00	$904.16	$3,781.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,692.00 / $13,743.77 / $21,606.00	Facility		$5,692.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $713.04 / $1,777.76 / $4,592.32	Professional		$713.04	$1,777.76	$4,592.32
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 $2,068.07 / $2,416.69 / $3,707.29	Facility		$2,068.07	$2,416.69	$3,707.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,158.92 / $3,154.94 / $3,585.16	Professional		$1,158.92	$3,154.94	$3,585.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $772.91 / $1,051.90 / $1,802.95	Facility		$772.91	$1,051.90	$1,802.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $772.91 / $1,497.65 / $8,384.00	Facility		$772.91	$1,497.65	$8,384.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $816.28 / $1,468.61 / $5,872.80	Professional		$816.28	$1,468.61	$5,872.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $469.18 / $1,523.25	Professional		$66.47	$469.18	$1,523.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $772.91 / $1,051.90 / $1,802.95	Facility		$772.91	$1,051.90	$1,802.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,570.40 / $1,913.47 / $2,856.44	Professional		$1,570.40	$1,913.47	$2,856.44
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 $1,476.06 / $3,639.50 / $5,872.80	Professional		$1,476.06	$3,639.50	$5,872.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,556.88 / $2,556.88 / $2,556.88	Professional		$2,556.88	$2,556.88	$2,556.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,278.99 / $3,863.37 / $5,020.95	Professional		$1,278.99	$3,863.37	$5,020.95
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $816.28 / $1,412.13 / $3,311.95	Professional		$816.28	$1,412.13	$3,311.95