Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $750.30 / $1,585.13 / $14,482.00	Facility		$750.30	$1,585.13	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $706.96 / $806.93 / $5,574.40	Professional		$706.96	$806.93	$5,574.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $738.25 / $1,731.45 / $4,599.80	Professional		$738.25	$1,731.45	$4,599.80
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 $2,001.39 / $2,338.78 / $3,587.75	Facility		$2,001.39	$2,338.78	$3,587.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,185.89 / $3,066.16 / $3,484.28	Professional		$1,185.89	$3,066.16	$3,484.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $750.30 / $1,125.45 / $1,761.25	Facility		$750.30	$1,125.45	$1,761.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $750.30 / $1,541.01 / $13,250.00	Facility		$750.30	$1,541.01	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $838.83 / $1,540.72 / $5,722.48	Professional		$838.83	$1,540.72	$5,722.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $461.05 / $1,507.24	Professional		$66.47	$461.05	$1,507.24
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $750.30 / $1,125.45 / $1,761.25	Facility		$750.30	$1,125.45	$1,761.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,534.00 / $1,869.12 / $2,790.23	Professional		$1,534.00	$1,869.12	$2,790.23
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 $1,434.51 / $3,674.10 / $5,722.48	Professional		$1,434.51	$3,674.10	$5,722.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,475.27 / $2,475.27 / $2,475.27	Professional		$2,475.27	$2,475.27	$2,475.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,918.49 / $3,805.83 / $4,879.58	Professional		$1,918.49	$3,805.83	$4,879.58
United Facility/Professional Facility Modifier Low / Median / High Price $5,660.81 / $11,608.00 / $13,980.00	Facility		$5,660.81	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $798.66 / $1,503.78 / $3,525.89	Professional		$798.66	$1,503.78	$3,525.89