Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $775.92 / $1,602.61 / $14,482.00	Facility		$775.92	$1,602.61	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $735.46 / $796.58 / $3,447.29	Professional		$735.46	$796.58	$3,447.29
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 $696.84 / $1,760.44 / $4,803.93	Professional		$696.84	$1,760.44	$4,803.93
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 $2,076.17 / $2,426.17 / $3,721.82	Facility		$2,076.17	$2,426.17	$3,721.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,198.21 / $3,285.68 / $3,941.13	Professional		$1,198.21	$3,285.68	$3,941.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $751.28 / $932.80 / $1,644.95	Facility		$751.28	$932.80	$1,644.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $775.92 / $1,432.32 / $11,598.00	Facility		$775.92	$1,432.32	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $820.07 / $1,520.73 / $5,818.96	Professional		$820.07	$1,520.73	$5,818.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $463.50 / $1,474.97	Professional		$66.47	$463.50	$1,474.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $751.28 / $911.71 / $1,644.95	Facility		$751.28	$911.71	$1,644.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,540.50 / $1,877.04 / $2,802.05	Professional		$1,540.50	$1,877.04	$2,802.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,143.35 / $9,143.35 / $25,239.65	Facility		$9,143.35	$9,143.35	$25,239.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,471.94 / $3,605.95 / $5,818.96	Professional		$1,471.94	$3,605.95	$5,818.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,588.37 / $2,588.37 / $2,588.37	Professional		$2,588.37	$2,588.37	$2,588.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,108.15 / $3,917.08 / $5,006.91	Professional		$2,108.15	$3,917.08	$5,006.91
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 $808.28 / $1,473.39 / $3,292.23	Professional		$808.28	$1,473.39	$3,292.23