Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $774.57 / $1,636.00 / $14,482.00	Facility		$774.57	$1,636.00	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $742.03 / $817.56 / $4,165.37	Professional		$742.03	$817.56	$4,165.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $753.72 / $1,787.47 / $4,754.70	Professional		$753.72	$1,787.47	$4,754.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,560.77 / $7,560.77 / $7,560.77	Facility		$7,560.77	$7,560.77	$7,560.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,068.07 / $2,416.69 / $3,707.29	Facility		$2,068.07	$2,416.69	$3,707.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,169.20 / $3,167.38 / $3,599.30	Professional		$1,169.20	$3,167.38	$3,599.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $774.57 / $1,094.00 / $1,711.80	Facility		$774.57	$1,094.00	$1,711.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $774.57 / $1,612.31 / $15,090.00	Facility		$774.57	$1,612.31	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $855.03 / $1,658.07 / $5,915.04	Professional		$855.03	$1,658.07	$5,915.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $469.00 / $1,525.19	Professional		$66.47	$469.00	$1,525.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $774.57 / $1,094.00 / $1,711.80	Facility		$774.57	$1,094.00	$1,711.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,589.90 / $1,937.23 / $2,891.91	Professional		$1,589.90	$1,937.23	$2,891.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,266.79 / $10,266.79 / $28,340.90	Facility		$10,266.79	$10,266.79	$28,340.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,481.87 / $3,785.55 / $5,915.04	Professional		$1,481.87	$3,785.55	$5,915.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,558.63 / $2,558.63 / $2,558.63	Professional		$2,558.63	$2,558.63	$2,558.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,415.87 / $3,923.54 / $5,040.66	Professional		$2,415.87	$3,923.54	$5,040.66
United Facility/Professional Facility Modifier Low / Median / High Price $6,154.00 / $11,891.00 / $15,090.00	Facility		$6,154.00	$11,891.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $842.11 / $1,589.97 / $3,632.84	Professional		$842.11	$1,589.97	$3,632.84