Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $822.06 / $1,701.41 / $14,482.00	Facility		$822.06	$1,701.41	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $679.20 / $841.03 / $3,222.74	Professional		$679.20	$841.03	$3,222.74
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 $742.11 / $1,878.63 / $4,870.95	Professional		$742.11	$1,878.63	$4,870.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11,022.93 / $11,022.93 / $11,022.93	Facility		$11,022.93	$11,022.93	$11,022.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,198.73 / $2,569.39 / $3,941.52	Facility		$2,198.73	$2,569.39	$3,941.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,285.68 / $3,486.12 / $4,175.72	Professional		$1,285.68	$3,486.12	$4,175.72
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $822.06 / $1,051.90 / $1,742.77	Facility		$822.06	$1,051.90	$1,742.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $822.06 / $1,525.28 / $11,598.00	Facility		$822.06	$1,525.28	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $873.60 / $1,648.18 / $6,168.88	Professional		$873.60	$1,648.18	$6,168.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $485.41 / $1,563.49	Professional		$94.25	$485.41	$1,563.49
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $822.06 / $1,051.90 / $1,742.77	Facility		$822.06	$1,051.90	$1,742.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,636.70 / $1,994.26 / $2,977.03	Professional		$1,636.70	$1,994.26	$2,977.03
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 $1,559.55 / $3,836.60 / $6,168.88	Professional		$1,559.55	$3,836.60	$6,168.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,739.25 / $2,739.25 / $2,739.25	Professional		$2,739.25	$2,739.25	$2,739.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,195.92 / $4,151.02 / $5,304.92	Professional		$2,195.92	$4,151.02	$5,304.92
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 $873.84 / $1,565.33 / $3,564.74	Professional		$873.84	$1,565.33	$3,564.74