Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $822.87 / $1,735.94 / $14,482.00	Facility		$822.87	$1,735.94	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $822.87 / $1,335.95 / $8,896.00	Professional		$822.87	$1,335.95	$8,896.00
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 $805.86 / $1,675.00 / $5,053.47	Professional		$805.86	$1,675.00	$5,053.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9,902.09 / $9,902.09 / $9,902.09	Facility		$9,902.09	$9,902.09	$9,902.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,194.23 / $2,564.13 / $3,933.44	Facility		$2,194.23	$2,564.13	$3,933.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,296.20 / $3,363.72 / $3,822.41	Professional		$1,296.20	$3,363.72	$3,822.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $822.87 / $1,234.31 / $1,818.54	Facility		$822.87	$1,234.31	$1,818.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $822.87 / $1,658.79 / $15,090.00	Facility		$822.87	$1,658.79	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $926.51 / $1,668.78 / $6,285.52	Professional		$926.51	$1,668.78	$6,285.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $503.39 / $1,603.51	Professional		$65.66	$503.39	$1,603.51
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $822.87 / $1,191.36 / $1,818.54	Facility		$822.87	$1,191.36	$1,818.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,687.40 / $2,056.03 / $3,069.25	Professional		$1,687.40	$2,056.03	$3,069.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,243.77 / $10,243.77 / $28,277.30	Facility		$10,243.77	$10,243.77	$28,277.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,573.73 / $4,030.15 / $6,285.52	Professional		$1,573.73	$4,030.15	$6,285.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,719.39 / $2,719.39 / $2,719.39	Professional		$2,719.39	$2,719.39	$2,719.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,441.32 / $4,172.81 / $5,353.12	Professional		$2,441.32	$4,172.81	$5,353.12
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,090.00	Facility		$8,627.00	$12,373.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $882.39 / $1,623.28 / $3,667.44	Professional		$882.39	$1,623.28	$3,667.44