Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $586.67 / $1,242.16 / $14,482.00	Facility		$586.67	$1,242.16	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $540.58 / $603.03 / $2,394.34	Professional		$540.58	$603.03	$2,394.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $8,139.00 / $11,136.00	Facility		$5,060.00	$8,139.00	$11,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $569.35 / $1,353.88 / $3,438.23	Professional		$569.35	$1,353.88	$3,438.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,822.54 / $4,822.54 / $4,822.54	Facility		$4,822.54	$4,822.54	$4,822.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,574.26 / $1,839.64 / $2,822.06	Facility		$1,574.26	$1,839.64	$2,822.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $968.97 / $2,405.10 / $2,733.06	Professional		$968.97	$2,405.10	$2,733.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $586.67 / $880.02 / $1,296.56	Facility		$586.67	$880.02	$1,296.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $586.67 / $1,189.07 / $11,100.00	Facility		$586.67	$1,189.07	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $676.36 / $1,282.68 / $5,297.48	Professional		$676.36	$1,282.68	$5,297.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $358.17 / $1,135.19	Professional		$66.47	$358.17	$1,135.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $586.67 / $860.51 / $1,296.56	Facility		$586.67	$860.51	$1,296.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,203.80 / $1,466.78 / $2,189.62	Professional		$1,203.80	$1,466.78	$2,189.62
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 $1,125.23 / $2,850.40 / $5,297.48	Professional		$1,125.23	$2,850.40	$5,297.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,933.54 / $1,933.54 / $1,933.54	Professional		$1,933.54	$1,933.54	$1,933.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,350.05 / $2,963.52 / $3,827.52	Professional		$1,350.05	$2,963.52	$3,827.52
United Facility/Professional Facility Modifier Low / Median / High Price $4,240.00 / $9,158.00 / $12,062.00	Facility		$4,240.00	$9,158.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $627.09 / $1,198.68 / $2,593.86	Professional		$627.09	$1,198.68	$2,593.86