Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $347.76 / $735.68 / $3,119.00	Facility		$347.76	$735.68	$3,119.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.76 / $488.65 / $1,601.14	Professional		$347.76	$488.65	$1,601.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $441.74 / $802.53 / $2,144.79	Professional		$441.74	$802.53	$2,144.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,971.90 / $2,971.90 / $2,971.90	Facility		$2,971.90	$2,971.90	$2,971.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,301.22 / $1,520.58 / $2,332.60	Facility		$1,301.22	$1,520.58	$2,332.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $605.29 / $1,251.90 / $2,141.32	Professional		$605.29	$1,251.90	$2,141.32
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $347.76 / $521.64 / $1,001.75	Facility		$347.76	$521.64	$1,001.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $356.50 / $611.87 / $4,377.80	Facility		$356.50	$611.87	$4,377.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $544.29 / $1,125.92 / $3,834.04	Professional		$544.29	$1,125.92	$3,834.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $291.90 / $947.18	Professional		$52.59	$291.90	$947.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $347.76 / $521.64 / $1,001.75	Facility		$347.76	$521.64	$1,001.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $810.87 / $1,147.69 / $1,672.81	Professional		$810.87	$1,147.69	$1,672.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,469.60 / $2,469.60 / $2,556.36	Facility		$2,469.60	$2,469.60	$2,556.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $746.20 / $2,077.07 / $3,834.04	Professional		$746.20	$2,077.07	$3,834.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.33 / $2,275.42 / $3,140.14	Professional		$1,096.33	$2,275.42	$3,140.14
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $528.20 / $1,009.53 / $2,100.37	Professional		$528.20	$1,009.53	$2,100.37