Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $743.55 / $1,570.84 / $14,482.00	Facility		$743.55	$1,570.84	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $712.62 / $776.47 / $3,483.47	Professional		$712.62	$776.47	$3,483.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $12,444.00	Facility		$5,169.00	$8,408.00	$12,444.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $726.86 / $1,715.88 / $4,367.10	Professional		$726.86	$1,715.88	$4,367.10
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 $1,984.27 / $2,318.77 / $3,557.06	Facility		$1,984.27	$2,318.77	$3,557.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,221.76 / $3,041.37 / $3,456.10	Professional		$1,221.76	$3,041.37	$3,456.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $743.55 / $1,115.33 / $1,643.25	Facility		$743.55	$1,115.33	$1,643.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $743.55 / $1,518.42 / $13,120.00	Facility		$743.55	$1,518.42	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $866.41 / $1,639.71 / $6,283.54	Professional		$866.41	$1,639.71	$6,283.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $446.18 / $1,482.52	Professional		$66.47	$446.18	$1,482.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $743.55 / $1,076.81 / $1,643.25	Facility		$743.55	$1,076.81	$1,643.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,526.20 / $1,859.62 / $2,776.04	Professional		$1,526.20	$1,859.62	$2,776.04
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 $1,422.93 / $3,643.80 / $6,283.54	Professional		$1,422.93	$3,643.80	$6,283.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,455.88 / $2,455.88 / $2,455.88	Professional		$2,455.88	$2,455.88	$2,455.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,747.95 / $3,770.24 / $4,840.16	Professional		$1,747.95	$3,770.24	$4,840.16
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $835.67 / $1,513.81 / $3,337.72	Professional		$835.67	$1,513.81	$3,337.72