Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $747.71 / $1,577.61 / $14,482.00	Facility		$747.71	$1,577.61	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $716.97 / $779.81 / $3,505.56	Professional		$716.97	$779.81	$3,505.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,287.00 / $13,743.77 / $21,606.00	Facility		$9,287.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $733.64 / $1,528.07 / $4,588.47	Professional		$733.64	$1,528.07	$4,588.47
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 $1,993.28 / $2,329.30 / $3,573.21	Facility		$1,993.28	$2,329.30	$3,573.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,227.14 / $3,056.45 / $3,473.24	Professional		$1,227.14	$3,056.45	$3,473.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $747.71 / $1,051.74 / $1,652.44	Facility		$747.71	$1,051.74	$1,652.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $747.71 / $1,519.38 / $11,598.00	Facility		$747.71	$1,519.38	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $872.26 / $1,637.07 / $6,555.30	Professional		$872.26	$1,637.07	$6,555.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $446.18 / $1,436.36	Professional		$66.47	$446.18	$1,436.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $747.71 / $1,046.79 / $1,652.44	Facility		$747.71	$1,046.79	$1,652.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,533.35 / $1,868.33 / $2,789.05	Professional		$1,533.35	$1,868.33	$2,789.05
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 $1,429.97 / $3,666.90 / $6,555.30	Professional		$1,429.97	$3,666.90	$6,555.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,469.16 / $2,469.16 / $2,469.16	Professional		$2,469.16	$2,469.16	$2,469.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,563.21 / $3,791.87 / $4,864.16	Professional		$1,563.21	$3,791.87	$4,864.16
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $842.76 / $1,574.76 / $3,336.88	Professional		$842.76	$1,574.76	$3,336.88