Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.60 / $1,166.15 / $14,482.00	Facility		$549.60	$1,166.15	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $483.61 / $575.03 / $2,202.73	Professional		$483.61	$575.03	$2,202.73
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 $532.55 / $1,268.30 / $3,366.38	Professional		$532.55	$1,268.30	$3,366.38
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 $1,477.84 / $1,726.97 / $2,649.22	Facility		$1,477.84	$1,726.97	$2,649.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $863.07 / $2,256.03 / $2,563.67	Professional		$863.07	$2,256.03	$2,563.67
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $549.60 / $824.40 / $1,295.73	Facility		$549.60	$824.40	$1,295.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $549.60 / $1,109.66 / $11,598.00	Facility		$549.60	$1,109.66	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $610.85 / $1,106.94 / $4,201.52	Professional		$610.85	$1,106.94	$4,201.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $330.98 / $1,077.80	Professional		$61.84	$330.98	$1,077.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $549.60 / $824.40 / $1,295.73	Facility		$549.60	$824.40	$1,295.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,129.70 / $1,376.50 / $2,054.84	Professional		$1,129.70	$1,376.50	$2,054.84
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 $1,055.49 / $2,666.10 / $4,201.52	Professional		$1,055.49	$2,666.10	$4,201.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,811.52 / $1,811.52 / $1,811.52	Professional		$1,811.52	$1,811.52	$1,811.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,136.88 / $2,775.73 / $3,590.30	Professional		$1,136.88	$2,775.73	$3,590.30
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 $601.35 / $1,071.97 / $2,426.15	Professional		$601.35	$1,071.97	$2,426.15