Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $763.97 / $1,613.07 / $14,482.00	Facility		$763.97	$1,613.07	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $731.87 / $797.38 / $3,565.98	Professional		$731.87	$797.38	$3,565.98
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 $743.08 / $1,763.01 / $4,686.66	Professional		$743.08	$1,763.01	$4,686.66
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 $2,041.04 / $2,385.11 / $3,658.82	Facility		$2,041.04	$2,385.11	$3,658.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,153.06 / $3,125.32 / $3,551.50	Professional		$1,153.06	$3,125.32	$3,551.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $763.97 / $1,108.66 / $1,673.71	Facility		$763.97	$1,108.66	$1,673.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $763.97 / $1,551.92 / $13,250.00	Facility		$763.97	$1,551.92	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $847.29 / $1,566.54 / $5,864.72	Professional		$847.29	$1,566.54	$5,864.72
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 $763.97 / $1,105.02 / $1,673.71	Facility		$763.97	$1,105.02	$1,673.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,566.50 / $1,908.72 / $2,849.34	Professional		$1,566.50	$1,908.72	$2,849.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,376.34 / $10,376.34 / $28,643.25	Facility		$10,376.34	$10,376.34	$28,643.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,462.19 / $3,730.10 / $5,864.72	Professional		$1,462.19	$3,730.10	$5,864.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,521.98 / $2,521.98 / $2,521.98	Professional		$2,521.98	$2,521.98	$2,521.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,233.05 / $3,867.57 / $4,973.71	Professional		$2,233.05	$3,867.57	$4,973.71
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $825.74 / $1,492.04 / $3,394.39	Professional		$825.74	$1,492.04	$3,394.39