Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $415.14 / $881.73 / $14,482.00	Facility		$415.14	$881.73	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $395.96 / $433.57 / $1,882.75	Professional		$395.96	$433.57	$1,882.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $8,139.00 / $11,136.00	Facility		$5,060.00	$8,139.00	$11,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.55 / $958.01 / $2,538.44	Professional		$398.55	$958.01	$2,538.44
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 $1,119.19 / $1,307.85 / $2,006.30	Facility		$1,119.19	$1,307.85	$2,006.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $627.27 / $1,706.30 / $1,938.98	Professional		$627.27	$1,706.30	$1,938.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $415.14 / $587.82 / $979.70	Facility		$415.14	$587.82	$979.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $415.14 / $842.54 / $11,100.00	Facility		$415.14	$842.54	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $441.15 / $797.35 / $4,616.50	Professional		$441.15	$797.35	$4,616.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.50 / $294.87 / $914.45	Professional		$56.50	$294.87	$914.45
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $415.14 / $581.20 / $979.70	Facility		$415.14	$581.20	$979.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $852.15 / $1,038.31 / $1,550.00	Professional		$852.15	$1,038.31	$1,550.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,244.77 / $3,244.77 / $8,957.00	Facility		$3,244.77	$3,244.77	$8,957.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $798.29 / $1,969.40 / $4,616.50	Professional		$798.29	$1,969.40	$4,616.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,365.99 / $1,365.99 / $1,365.99	Professional		$1,365.99	$1,365.99	$1,365.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,323.99 / $2,079.21 / $2,715.43	Professional		$1,323.99	$2,079.21	$2,715.43
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 $433.27 / $764.13 / $1,792.15	Professional		$433.27	$764.13	$1,792.15