Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.23 / $1,334.39 / $14,482.00	Facility		$630.23	$1,334.39	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.84 / $662.76 / $2,578.38	Professional		$602.84	$662.76	$2,578.38
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 $613.73 / $1,454.38 / $3,695.79	Professional		$613.73	$1,454.38	$3,695.79
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 $1,688.70 / $1,973.38 / $3,027.21	Facility		$1,688.70	$1,973.38	$3,027.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $955.33 / $2,581.73 / $2,933.79	Professional		$955.33	$2,581.73	$2,933.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $630.23 / $904.94 / $1,397.30	Facility		$630.23	$904.94	$1,397.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $630.23 / $1,317.33 / $11,100.00	Facility		$630.23	$1,317.33	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $699.94 / $1,235.52 / $6,052.96	Professional		$699.94	$1,235.52	$6,052.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $389.42 / $1,251.90	Professional		$66.47	$389.42	$1,251.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $630.23 / $904.94 / $1,397.30	Facility		$630.23	$904.94	$1,397.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,294.15 / $1,576.87 / $2,353.96	Professional		$1,294.15	$1,576.87	$2,353.96
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 $1,207.89 / $3,069.50 / $6,052.96	Professional		$1,207.89	$3,069.50	$6,052.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,078.38 / $2,078.38 / $2,078.38	Professional		$2,078.38	$2,078.38	$2,078.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,060.16 / $3,185.86 / $4,108.72	Professional		$2,060.16	$3,185.86	$4,108.72
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 $670.54 / $1,235.52 / $2,802.45	Professional		$670.54	$1,235.52	$2,802.45