Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $874.22 / $1,800.65 / $14,482.00	Facility		$874.22	$1,800.65	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $827.74 / $895.02 / $3,938.62	Professional		$827.74	$895.02	$3,938.62
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 $801.40 / $2,017.43 / $5,441.47	Professional		$801.40	$2,017.43	$5,441.47
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 $2,338.41 / $2,732.61 / $4,191.89	Facility		$2,338.41	$2,732.61	$4,191.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,362.77 / $3,695.14 / $4,432.39	Professional		$1,362.77	$3,695.14	$4,432.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $874.22 / $1,177.50 / $1,853.35	Facility		$874.22	$1,177.50	$1,853.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $874.22 / $1,638.96 / $11,100.00	Facility		$874.22	$1,638.96	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $936.36 / $1,804.52 / $6,898.69	Professional		$936.36	$1,804.52	$6,898.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $498.98 / $1,628.49	Professional		$94.25	$498.98	$1,628.49
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $874.22 / $1,121.96 / $1,853.35	Facility		$874.22	$1,121.96	$1,853.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,729.00 / $2,106.71 / $3,144.92	Professional		$1,729.00	$2,106.71	$3,144.92
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 $1,655.42 / $4,119.89 / $6,898.69	Professional		$1,655.42	$4,119.89	$6,898.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,918.67 / $2,918.67 / $2,918.67	Professional		$2,918.67	$2,918.67	$2,918.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,405.63 / $4,452.58 / $5,631.01	Professional		$2,405.63	$4,452.58	$5,631.01
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $903.42 / $1,647.96 / $3,773.83	Professional		$903.42	$1,647.96	$3,773.83