Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $888.31 / $1,872.41 / $14,482.00	Facility		$888.31	$1,872.41	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $852.42 / $925.80 / $4,166.82	Professional		$852.42	$925.80	$4,166.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,139.00 / $15,055.00 / $22,609.00	Facility		$8,139.00	$15,055.00	$22,609.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.83 / $2,049.94 / $5,458.19	Professional		$870.83	$2,049.94	$5,458.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14,551.22 / $14,551.22 / $14,551.22	Facility		$14,551.22	$14,551.22	$14,551.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,365.44 / $2,764.20 / $4,240.35	Facility		$2,365.44	$2,764.20	$4,240.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,398.67 / $3,628.30 / $4,123.06	Professional		$1,398.67	$3,628.30	$4,123.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $888.31 / $1,302.00 / $1,963.17	Facility		$888.31	$1,302.00	$1,963.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $888.31 / $1,789.19 / $13,250.00	Facility		$888.31	$1,789.19	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,037.40 / $1,931.03 / $7,172.28	Professional		$1,037.40	$1,931.03	$7,172.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $557.31 / $1,751.19	Professional		$66.47	$557.31	$1,751.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $888.31 / $1,286.67 / $1,963.17	Facility		$888.31	$1,286.67	$1,963.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,821.95 / $2,219.98 / $3,313.99	Professional		$1,821.95	$2,219.98	$3,313.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13,629.66 / $13,629.66 / $37,623.85	Facility		$13,629.66	$13,629.66	$37,623.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,697.52 / $4,358.60 / $7,172.28	Professional		$1,697.52	$4,358.60	$7,172.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,937.20 / $2,937.20 / $2,937.20	Professional		$2,937.20	$2,937.20	$2,937.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,046.38 / $4,508.33 / $5,774.24	Professional		$2,046.38	$4,508.33	$5,774.24
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 $1,002.30 / $1,833.18 / $3,966.33	Professional		$1,002.30	$1,833.18	$3,966.33