Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $833.70 / $1,725.57 / $14,482.00	Facility		$833.70	$1,725.57	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $791.02 / $858.33 / $3,721.52	Professional		$791.02	$858.33	$3,721.52
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 $753.97 / $1,893.83 / $5,177.57	Professional		$753.97	$1,893.83	$5,177.57
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 $2,228.46 / $2,604.14 / $3,994.82	Facility		$2,228.46	$2,604.14	$3,994.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,286.98 / $3,533.36 / $4,234.84	Professional		$1,286.98	$3,533.36	$4,234.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $833.70 / $1,177.50 / $1,917.30	Facility		$833.70	$1,177.50	$1,917.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $833.70 / $1,550.73 / $11,100.00	Facility		$833.70	$1,550.73	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $875.48 / $1,663.76 / $6,258.24	Professional		$875.48	$1,663.76	$6,258.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $496.31 / $1,620.17	Professional		$94.25	$496.31	$1,620.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $833.70 / $1,177.50 / $1,917.30	Facility		$833.70	$1,177.50	$1,917.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,660.75 / $2,023.56 / $3,020.78	Professional		$1,660.75	$2,023.56	$3,020.78
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 $1,581.64 / $3,892.80 / $6,258.24	Professional		$1,581.64	$3,892.80	$6,258.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,777.12 / $2,777.12 / $2,777.12	Professional		$2,777.12	$2,777.12	$2,777.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,247.04 / $4,210.03 / $5,380.03	Professional		$2,247.04	$4,210.03	$5,380.03
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 $875.48 / $1,595.93 / $3,476.43	Professional		$875.48	$1,595.93	$3,476.43