Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $773.87 / $1,634.22 / $14,482.00	Facility		$773.87	$1,634.22	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $742.19 / $808.05 / $3,631.51	Professional		$742.19	$808.05	$3,631.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,139.00 / $15,055.00 / $22,609.00	Facility		$8,139.00	$15,055.00	$22,609.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $759.98 / $1,785.86 / $4,750.64	Professional		$759.98	$1,785.86	$4,750.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20,369.36 / $20,369.36 / $20,369.36	Facility		$20,369.36	$20,369.36	$20,369.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,063.56 / $2,411.44 / $3,699.21	Facility		$2,063.56	$2,411.44	$3,699.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,167.18 / $3,164.39 / $3,595.90	Professional		$1,167.18	$3,164.39	$3,595.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $773.87 / $1,063.97 / $1,710.25	Facility		$773.87	$1,063.97	$1,710.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $773.87 / $1,600.52 / $13,250.00	Facility		$773.87	$1,600.52	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $835.06 / $1,663.81 / $5,914.16	Professional		$835.06	$1,663.81	$5,914.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $479.17 / $1,525.19	Professional		$66.47	$479.17	$1,525.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $773.87 / $1,057.22 / $1,710.25	Facility		$773.87	$1,057.22	$1,710.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,589.25 / $1,936.44 / $2,890.72	Professional		$1,589.25	$1,936.44	$2,890.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $18,487.53 / $18,487.53 / $51,033.70	Facility		$18,487.53	$18,487.53	$51,033.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,480.47 / $3,798.65 / $5,914.16	Professional		$1,480.47	$3,798.65	$5,914.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,556.44 / $2,556.44 / $2,556.44	Professional		$2,556.44	$2,556.44	$2,556.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,303.08 / $3,925.90 / $5,035.95	Professional		$2,303.08	$3,925.90	$5,035.95
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $831.50 / $1,601.51 / $3,572.66	Professional		$831.50	$1,601.51	$3,572.66