Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $653.52 / $1,382.49 / $14,482.00	Facility		$653.52	$1,382.49	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $624.45 / $679.30 / $3,046.10	Professional		$624.45	$679.30	$3,046.10
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 $638.84 / $1,508.12 / $4,005.04	Professional		$638.84	$1,508.12	$4,005.04
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 $1,744.57 / $2,038.67 / $3,127.37	Facility		$1,744.57	$2,038.67	$3,127.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,077.73 / $2,668.08 / $3,031.91	Professional		$1,077.73	$2,668.08	$3,031.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $653.52 / $914.93 / $1,536.10	Facility		$653.52	$914.93	$1,536.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $653.52 / $1,332.28 / $11,100.00	Facility		$653.52	$1,332.28	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $756.11 / $1,433.84 / $5,932.82	Professional		$756.11	$1,433.84	$5,932.82
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 $653.52 / $914.93 / $1,536.10	Facility		$653.52	$914.93	$1,536.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,333.80 / $1,625.18 / $2,426.08	Professional		$1,333.80	$1,625.18	$2,426.08
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 $1,248.28 / $3,186.30 / $5,932.82	Professional		$1,248.28	$3,186.30	$5,932.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,148.19 / $2,148.19 / $2,148.19	Professional		$2,148.19	$2,148.19	$2,148.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,193.72 / $3,298.79 / $4,246.08	Professional		$1,193.72	$3,298.79	$4,246.08
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 $721.97 / $1,288.92 / $2,899.53	Professional		$721.97	$1,288.92	$2,899.53