Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.91 / $2,040.19 / $14,482.00	Facility		$988.91	$2,040.19	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $938.82 / $1,019.36 / $4,493.30	Professional		$938.82	$1,019.36	$4,493.30
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 $918.22 / $2,282.09 / $6,261.56	Professional		$918.22	$2,282.09	$6,261.56
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 $2,638.48 / $3,083.27 / $4,729.82	Facility		$2,638.48	$3,083.27	$4,729.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,539.65 / $4,174.75 / $5,017.43	Professional		$1,539.65	$4,174.75	$5,017.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $960.58 / $1,244.17 / $2,096.48	Facility		$960.58	$1,244.17	$2,096.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $988.91 / $1,893.28 / $11,598.00	Facility		$988.91	$1,893.28	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,070.51 / $2,058.64 / $7,528.50	Professional		$1,070.51	$2,058.64	$7,528.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $584.01 / $1,917.08	Professional		$94.25	$584.01	$1,917.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $960.58 / $1,190.19 / $2,096.48	Facility		$960.58	$1,190.19	$2,096.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,964.30 / $2,393.42 / $3,572.91	Professional		$1,964.30	$2,393.42	$3,572.91
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 $1,873.93 / $4,700.10 / $7,528.50	Professional		$1,873.93	$4,700.10	$7,528.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,301.15 / $3,301.15 / $3,301.15	Professional		$3,301.15	$3,301.15	$3,301.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,781.53 / $5,045.14 / $6,374.27	Professional		$2,781.53	$5,045.14	$6,374.27
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 $1,039.74 / $1,851.74 / $4,305.29	Professional		$1,039.74	$1,851.74	$4,305.29