Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $585.26 / $1,238.71 / $14,482.00	Facility		$585.26	$1,238.71	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $559.78 / $612.42 / $2,721.88	Professional		$559.78	$612.42	$2,721.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $569.82 / $1,170.50 / $3,434.49	Professional		$569.82	$1,170.50	$3,434.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,198.35 / $2,198.35 / $2,198.35	Facility		$2,198.35	$2,198.35	$2,198.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,567.95 / $1,832.27 / $2,810.75	Facility		$1,567.95	$1,832.27	$2,810.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $807.60 / $2,397.88 / $2,724.86	Professional		$807.60	$2,397.88	$2,724.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $528.16 / $684.75 / $1,240.75	Facility		$528.16	$684.75	$1,240.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $550.54 / $1,183.66 / $5,261.00	Facility		$550.54	$1,183.66	$5,261.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $623.07 / $1,144.55 / $4,470.72	Professional		$623.07	$1,144.55	$4,470.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $358.17 / $1,135.19	Professional		$66.47	$358.17	$1,135.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $528.16 / $684.75 / $1,240.75	Facility		$528.16	$684.75	$1,240.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,201.20 / $1,463.62 / $2,184.89	Professional		$1,201.20	$1,463.62	$2,184.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,015.89 / $2,015.89 / $5,564.75	Facility		$2,015.89	$2,015.89	$5,564.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,121.85 / $2,847.15 / $4,470.72	Professional		$1,121.85	$2,847.15	$4,470.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,931.42 / $1,931.42 / $1,931.42	Professional		$1,931.42	$1,931.42	$1,931.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,641.99 / $2,959.74 / $3,816.04	Professional		$1,641.99	$2,959.74	$3,816.04
United Facility/Professional Facility Modifier Low / Median / High Price $2,723.00 / $3,912.00 / $5,865.00	Facility		$2,723.00	$3,912.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $598.48 / $1,055.54 / $2,590.91	Professional		$598.48	$1,055.54	$2,590.91