Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $619.20 / $1,313.64 / $14,482.00	Facility		$619.20	$1,313.64	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $535.27 / $776.14 / $5,652.80	Professional		$535.27	$776.14	$5,652.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $12,444.00	Facility		$5,169.00	$8,408.00	$12,444.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $600.54 / $1,428.91 / $3,671.76	Professional		$600.54	$1,428.91	$3,671.76
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 $1,663.47 / $1,943.89 / $2,981.98	Facility		$1,663.47	$1,943.89	$2,981.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $920.62 / $2,675.79 / $3,177.60	Professional		$920.62	$2,675.79	$3,177.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $619.20 / $875.76 / $1,459.60	Facility		$619.20	$875.76	$1,459.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $619.20 / $1,255.26 / $14,246.00	Facility		$619.20	$1,255.26	$14,246.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $654.29 / $1,208.16 / $4,710.96	Professional		$654.29	$1,208.16	$4,710.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $371.66 / $1,197.45	Professional		$66.47	$371.66	$1,197.45
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $619.20 / $875.76 / $1,459.60	Facility		$619.20	$875.76	$1,459.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,261.00 / $1,536.48 / $2,293.66	Professional		$1,261.00	$1,536.48	$2,293.66
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 $1,186.78 / $2,994.25 / $4,710.96	Professional		$1,186.78	$2,994.25	$4,710.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,033.61 / $2,033.61 / $2,033.61	Professional		$2,033.61	$2,033.61	$2,033.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,648.48 / $3,184.47 / $4,036.87	Professional		$1,648.48	$3,184.47	$4,036.87
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,090.00	Facility		$8,627.00	$12,373.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $649.97 / $1,208.16 / $2,724.77	Professional		$649.97	$1,208.16	$2,724.77