Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $727.97 / $1,537.88 / $14,482.00	Facility		$727.97	$1,537.88	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $697.68 / $760.60 / $3,406.13	Professional		$697.68	$760.60	$3,406.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,287.00 / $13,743.77 / $21,606.00	Facility		$9,287.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $713.11 / $1,679.94 / $4,463.96	Professional		$713.11	$1,679.94	$4,463.96
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 $1,942.81 / $2,270.33 / $3,482.75	Facility		$1,942.81	$2,270.33	$3,482.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,099.08 / $2,976.85 / $3,382.79	Professional		$1,099.08	$2,976.85	$3,382.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $727.97 / $1,057.14 / $1,608.81	Facility		$727.97	$1,057.14	$1,608.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $727.97 / $1,515.34 / $13,250.00	Facility		$727.97	$1,515.34	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $816.44 / $1,560.55 / $5,560.32	Professional		$816.44	$1,560.55	$5,560.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $432.10 / $1,427.72	Professional		$66.47	$432.10	$1,427.72
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $727.97 / $1,052.98 / $1,608.81	Facility		$727.97	$1,052.98	$1,608.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,495.00 / $1,821.60 / $2,719.29	Professional		$1,495.00	$1,821.60	$2,719.29
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,213.88 / $7,213.88 / $19,913.50	Facility		$7,213.88	$7,213.88	$19,913.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,392.74 / $3,562.90 / $5,560.32	Professional		$1,392.74	$3,562.90	$5,560.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,402.16 / $2,402.16 / $2,402.16	Professional		$2,402.16	$2,402.16	$2,402.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,162.54 / $3,686.24 / $4,737.53	Professional		$2,162.54	$3,686.24	$4,737.53
United Facility/Professional Facility Modifier Low / Median / High Price $5,660.81 / $11,608.00 / $13,980.00	Facility		$5,660.81	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $811.37 / $1,516.58 / $3,393.67	Professional		$811.37	$1,516.58	$3,393.67