Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $851.33 / $1,762.13 / $14,482.00	Facility		$851.33	$1,762.13	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $808.08 / $877.30 / $3,808.99	Professional		$808.08	$877.30	$3,808.99
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 $772.65 / $1,929.32 / $5,307.93	Professional		$772.65	$1,929.32	$5,307.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10,410.19 / $10,410.19 / $10,410.19	Facility		$10,410.19	$10,410.19	$10,410.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,274.42 / $2,657.85 / $4,077.21	Facility		$2,274.42	$2,657.85	$4,077.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,326.43 / $3,606.38 / $4,324.43	Professional		$1,326.43	$3,606.38	$4,324.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $851.33 / $1,060.50 / $1,804.82	Facility		$851.33	$1,060.50	$1,804.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $851.33 / $1,594.94 / $11,598.00	Facility		$851.33	$1,594.94	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $899.06 / $1,684.70 / $6,392.96	Professional		$899.06	$1,684.70	$6,392.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $500.46 / $1,622.82	Professional		$94.25	$500.46	$1,622.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $851.33 / $1,054.84 / $1,804.82	Facility		$851.33	$1,054.84	$1,804.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,696.50 / $2,067.12 / $3,085.80	Professional		$1,696.50	$2,067.12	$3,085.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,968.04 / $9,968.04 / $27,516.20	Facility		$9,968.04	$9,968.04	$27,516.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,615.10 / $3,984.30 / $6,392.96	Professional		$1,615.10	$3,984.30	$6,392.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,836.23 / $2,836.23 / $2,836.23	Professional		$2,836.23	$2,836.23	$2,836.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,435.31 / $4,301.22 / $5,493.86	Professional		$1,435.31	$4,301.22	$5,493.86
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 $864.71 / $1,553.74 / $3,625.71	Professional		$864.71	$1,553.74	$3,625.71