Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $853.63 / $1,711.21 / $14,482.00	Facility		$853.63	$1,711.21	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $820.88 / $913.46 / $4,030.64	Professional		$820.88	$913.46	$4,030.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $838.19 / $1,969.92 / $5,047.10	Professional		$838.19	$1,969.92	$5,047.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,507.48 / $1,507.48 / $1,507.48	Facility		$1,507.48	$1,507.48	$1,507.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,150.96 / $2,513.58 / $3,855.90	Facility		$2,150.96	$2,513.58	$3,855.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,301.64 / $3,317.69 / $3,770.10	Professional		$1,301.64	$3,317.69	$3,770.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $853.63 / $1,238.36 / $1,886.52	Facility		$853.63	$1,238.36	$1,886.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $853.63 / $1,675.00 / $5,639.00	Facility		$853.63	$1,675.00	$5,639.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $925.70 / $1,724.00 / $6,898.32	Professional		$925.70	$1,724.00	$6,898.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $510.50 / $1,636.13	Professional		$65.66	$510.50	$1,636.13
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $853.63 / $1,216.85 / $1,886.52	Facility		$853.63	$1,216.85	$1,886.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,699.10 / $2,070.29 / $3,090.53	Professional		$1,699.10	$2,070.29	$3,090.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,469.60 / $2,469.60 / $6,817.20	Facility		$2,469.60	$2,469.60	$6,817.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,552.20 / $4,216.14 / $6,898.32	Professional		$1,552.20	$4,216.14	$6,898.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,838.29 / $2,838.29 / $2,838.29	Professional		$2,838.29	$2,838.29	$2,838.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,705.32 / $4,342.07 / $5,279.95	Professional		$1,705.32	$4,342.07	$5,279.95
United Facility/Professional Facility Modifier Low / Median / High Price $2,723.00 / $3,912.00 / $5,865.00	Facility		$2,723.00	$3,912.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $925.70 / $1,697.83 / $3,836.70	Professional		$925.70	$1,697.83	$3,836.70