Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $906.96 / $1,869.50 / $14,482.00	Facility		$906.96	$1,869.50	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $859.42 / $930.16 / $4,098.47	Professional		$859.42	$930.16	$4,098.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,692.00 / $13,743.77 / $21,606.00	Facility		$5,692.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $834.62 / $1,813.91 / $5,646.77	Professional		$834.62	$1,813.91	$5,646.77
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 $2,424.01 / $2,832.65 / $4,345.35	Facility		$2,424.01	$2,832.65	$4,345.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,413.46 / $3,832.58 / $4,599.89	Professional		$1,413.46	$3,832.58	$4,599.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $906.96 / $1,329.42 / $2,077.23	Facility		$906.96	$1,329.42	$2,077.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $906.96 / $1,709.57 / $11,598.00	Facility		$906.96	$1,709.57	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $975.40 / $1,877.75 / $6,790.16	Professional		$975.40	$1,877.75	$6,790.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $543.62 / $1,729.93	Professional		$94.25	$543.62	$1,729.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $906.96 / $1,329.42 / $2,077.23	Facility		$906.96	$1,329.42	$2,077.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,796.60 / $2,189.09 / $3,267.88	Professional		$1,796.60	$2,189.09	$3,267.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,185.04 / $9,185.04 / $25,354.75	Facility		$9,185.04	$9,185.04	$25,354.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,717.98 / $4,287.10 / $6,790.16	Professional		$1,717.98	$4,287.10	$6,790.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,028.79 / $3,028.79 / $3,028.79	Professional		$3,028.79	$3,028.79	$3,028.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,762.16 / $4,623.05 / $5,843.81	Professional		$1,762.16	$4,623.05	$5,843.81
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 $973.98 / $1,848.78 / $3,901.26	Professional		$973.98	$1,848.78	$3,901.26