Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $855.34 / $1,804.03 / $14,482.00	Facility		$855.34	$1,804.03	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $807.73 / $891.77 / $3,960.22	Professional		$807.73	$891.77	$3,960.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $12,444.00	Facility		$5,169.00	$8,408.00	$12,444.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $837.41 / $1,973.86 / $5,267.18	Professional		$837.41	$1,973.86	$5,267.18
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 $2,280.73 / $2,665.22 / $4,088.51	Facility		$2,280.73	$2,665.22	$4,088.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,288.74 / $3,496.42 / $3,973.20	Professional		$1,288.74	$3,496.42	$3,973.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $855.34 / $1,202.69 / $1,885.58	Facility		$855.34	$1,202.69	$1,885.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $855.34 / $1,764.20 / $13,120.00	Facility		$855.34	$1,764.20	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $957.94 / $1,835.31 / $6,535.04	Professional		$957.94	$1,835.31	$6,535.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $532.70 / $1,653.08	Professional		$65.66	$532.70	$1,653.08
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $855.34 / $1,197.48 / $1,885.58	Facility		$855.34	$1,197.48	$1,885.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,753.70 / $2,136.82 / $3,189.85	Professional		$1,753.70	$2,136.82	$3,189.85
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 $1,635.81 / $4,190.20 / $6,535.04	Professional		$1,635.81	$4,190.20	$6,535.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,825.19 / $2,825.19 / $2,825.19	Professional		$2,825.19	$2,825.19	$2,825.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,216.92 / $4,336.60 / $5,564.34	Professional		$2,216.92	$4,336.60	$5,564.34
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $939.21 / $1,689.16 / $3,813.08	Professional		$939.21	$1,689.16	$3,813.08