Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $980.67 / $2,067.44 / $14,482.00	Facility		$980.67	$2,067.44	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $940.59 / $1,022.31 / $4,592.29	Professional		$940.59	$1,022.31	$4,592.29
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 $961.17 / $2,263.09 / $5,763.59	Professional		$961.17	$2,263.09	$5,763.59
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 $2,612.35 / $3,052.73 / $4,682.97	Facility		$2,612.35	$3,052.73	$4,682.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,545.46 / $4,005.46 / $4,551.66	Professional		$1,545.46	$4,005.46	$4,551.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $980.67 / $1,280.68 / $2,167.28	Facility		$980.67	$1,280.68	$2,167.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $980.67 / $1,975.55 / $13,120.00	Facility		$980.67	$1,975.55	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,143.02 / $2,104.00 / $7,486.96	Professional		$1,143.02	$2,104.00	$7,486.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $610.07 / $1,930.66	Professional		$66.47	$610.07	$1,930.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $980.67 / $1,273.15 / $2,167.28	Facility		$980.67	$1,273.15	$2,167.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,011.10 / $2,450.44 / $3,658.04	Professional		$2,011.10	$2,450.44	$3,658.04
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 $1,873.98 / $4,803.64 / $7,486.96	Professional		$1,873.98	$4,803.64	$7,486.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,241.21 / $3,241.21 / $3,241.21	Professional		$3,241.21	$3,241.21	$3,241.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,705.32 / $4,971.75 / $6,374.48	Professional		$1,705.32	$4,971.75	$6,374.48
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 $1,096.48 / $2,017.29 / $4,371.32	Professional		$1,096.48	$2,017.29	$4,371.32