Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $603.98 / $1,278.27 / $14,482.00	Facility		$603.98	$1,278.27	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $484.24 / $620.57 / $2,809.16	Professional		$484.24	$620.57	$2,809.16
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 $588.40 / $1,236.70 / $3,541.35	Professional		$588.40	$1,236.70	$3,541.35
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 $1,618.41 / $1,891.24 / $2,901.21	Facility		$1,618.41	$1,891.24	$2,901.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $958.32 / $2,473.88 / $2,811.23	Professional		$958.32	$2,473.88	$2,811.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $603.98 / $777.56 / $1,280.60	Facility		$603.98	$777.56	$1,280.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $603.98 / $1,221.46 / $13,120.00	Facility		$603.98	$1,221.46	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $653.51 / $1,273.64 / $4,946.76	Professional		$653.51	$1,273.64	$4,946.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $360.37 / $1,146.06	Professional		$65.66	$360.37	$1,146.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $603.98 / $757.67 / $1,280.60	Facility		$603.98	$757.67	$1,280.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,239.55 / $1,510.34 / $2,254.65	Professional		$1,239.55	$1,510.34	$2,254.65
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 $1,157.42 / $2,938.45 / $4,946.76	Professional		$1,157.42	$2,938.45	$4,946.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,991.52 / $1,991.52 / $1,991.52	Professional		$1,991.52	$1,991.52	$1,991.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,517.13 / $3,053.03 / $3,937.00	Professional		$1,517.13	$3,053.03	$3,937.00
United Facility/Professional Facility Modifier Low / Median / High Price $4,981.00 / $11,799.00 / $16,373.00	Facility		$4,981.00	$11,799.00	$16,373.00
United Facility/Professional Professional Modifier Low / Median / High Price $646.46 / $1,249.45 / $2,585.84	Professional		$646.46	$1,249.45	$2,585.84