Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $608.52 / $1,284.91 / $14,482.00	Facility		$608.52	$1,284.91	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $635.41 / $2,427.05	Professional		$533.91	$635.41	$2,427.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $14,586.00	Facility		$5,169.00	$8,408.00	$14,586.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $594.38 / $1,404.28 / $3,955.40	Professional		$594.38	$1,404.28	$3,955.40
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 $1,628.32 / $1,902.83 / $2,918.98	Facility		$1,628.32	$1,902.83	$2,918.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $919.52 / $2,609.94 / $3,119.78	Professional		$919.52	$2,609.94	$3,119.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $608.52 / $856.61 / $1,317.23	Facility		$608.52	$856.61	$1,317.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $608.52 / $1,227.80 / $14,246.00	Facility		$608.52	$1,227.80	$14,246.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $671.20 / $1,224.00 / $4,644.16	Professional		$671.20	$1,224.00	$4,644.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $360.37 / $1,146.06	Professional		$65.66	$360.37	$1,146.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $608.52 / $851.93 / $1,317.23	Facility		$608.52	$851.93	$1,317.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,246.70 / $1,519.06 / $2,267.65	Professional		$1,246.70	$1,519.06	$2,267.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,112.64 / $4,112.64 / $11,352.75	Facility		$4,112.64	$4,112.64	$11,352.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,165.18 / $2,973.20 / $4,644.16	Professional		$1,165.18	$2,973.20	$4,644.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,009.77 / $2,009.77 / $2,009.77	Professional		$2,009.77	$2,009.77	$2,009.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,250.57 / $3,142.82 / $3,963.42	Professional		$1,250.57	$3,142.82	$3,963.42
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 $665.16 / $1,213.07 / $2,705.61	Professional		$665.16	$1,213.07	$2,705.61