Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $765.27 / $1,616.63 / $14,482.00	Facility		$765.27	$1,616.63	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $733.68 / $799.35 / $3,588.78	Professional		$733.68	$799.35	$3,588.78
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 $751.02 / $1,766.00 / $4,694.93	Professional		$751.02	$1,766.00	$4,694.93
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 $2,041.94 / $2,386.17 / $3,660.44	Facility		$2,041.94	$2,386.17	$3,660.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,155.08 / $3,129.94 / $3,556.75	Professional		$1,155.08	$3,129.94	$3,556.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $765.27 / $1,077.75 / $1,796.25	Facility		$765.27	$1,077.75	$1,796.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $765.27 / $1,581.16 / $13,250.00	Facility		$765.27	$1,581.16	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $860.49 / $1,523.90 / $5,848.40	Professional		$860.49	$1,523.90	$5,848.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $479.17 / $1,525.19	Professional		$66.47	$479.17	$1,525.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $765.27 / $1,077.75 / $1,796.25	Facility		$765.27	$1,077.75	$1,796.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,571.70 / $1,915.06 / $2,858.80	Professional		$1,571.70	$1,915.06	$2,858.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,528.21 / $10,528.21 / $29,062.50	Facility		$10,528.21	$10,528.21	$29,062.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,464.37 / $3,753.95 / $5,848.40	Professional		$1,464.37	$3,753.95	$5,848.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,526.44 / $2,526.44 / $2,526.44	Professional		$2,526.44	$2,526.44	$2,526.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,299.54 / $3,879.65 / $4,981.10	Professional		$2,299.54	$3,879.65	$4,981.10
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 $856.42 / $1,575.38 / $3,416.09	Professional		$856.42	$1,575.38	$3,416.09