Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $830.10 / $1,709.35 / $14,482.00	Facility		$830.10	$1,709.35	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $755.54 / $843.96 / $3,734.47	Professional		$755.54	$843.96	$3,734.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $771.50 / $1,660.19 / $5,204.18	Professional		$771.50	$1,660.19	$5,204.18
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 $2,218.56 / $2,592.56 / $3,977.05	Facility		$2,218.56	$2,592.56	$3,977.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,294.66 / $3,510.46 / $4,203.14	Professional		$1,294.66	$3,510.46	$4,203.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $830.10 / $1,162.14 / $1,759.81	Facility		$830.10	$1,162.14	$1,759.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $830.10 / $1,575.41 / $11,598.00	Facility		$830.10	$1,575.41	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $898.71 / $1,710.98 / $6,192.16	Professional		$898.71	$1,710.98	$6,192.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $482.25 / $1,541.85	Professional		$94.25	$482.25	$1,541.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $830.10 / $1,162.00 / $1,759.81	Facility		$830.10	$1,162.00	$1,759.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,634.75 / $1,991.88 / $2,973.48	Professional		$1,634.75	$1,991.88	$2,973.48
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 $1,569.80 / $3,906.35 / $6,192.16	Professional		$1,569.80	$3,906.35	$6,192.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,767.55 / $2,767.55 / $2,767.55	Professional		$2,767.55	$2,767.55	$2,767.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,634.27 / $4,222.68 / $5,339.77	Professional		$1,634.27	$4,222.68	$5,339.77
United Facility/Professional Facility Modifier Low / Median / High Price $4,240.00 / $9,158.00 / $12,062.00	Facility		$4,240.00	$9,158.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $886.16 / $1,693.17 / $3,691.57	Professional		$886.16	$1,693.17	$3,691.57