Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $798.76 / $1,685.86 / $14,482.00	Facility		$798.76	$1,685.86	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $766.29 / $833.56 / $3,750.15	Professional		$766.29	$833.56	$3,750.15
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 $785.88 / $1,843.30 / $4,903.60	Professional		$785.88	$1,843.30	$4,903.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14,551.22 / $14,551.22 / $14,551.22	Facility		$14,551.22	$14,551.22	$14,551.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,128.44 / $2,487.26 / $3,815.52	Facility		$2,128.44	$2,487.26	$3,815.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,203.50 / $3,264.00 / $3,709.09	Professional		$1,203.50	$3,264.00	$3,709.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $798.76 / $1,123.78 / $1,765.26	Facility		$798.76	$1,123.78	$1,765.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $798.76 / $1,659.35 / $13,250.00	Facility		$798.76	$1,659.35	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $863.66 / $1,718.16 / $6,102.08	Professional		$863.66	$1,718.16	$6,102.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $490.51 / $1,575.17	Professional		$66.47	$490.51	$1,575.17
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $798.76 / $1,118.26 / $1,765.26	Facility		$798.76	$1,118.26	$1,765.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,639.95 / $1,998.22 / $2,982.94	Professional		$1,639.95	$1,998.22	$2,982.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13,629.66 / $13,629.66 / $37,623.85	Facility		$13,629.66	$13,629.66	$37,623.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,527.07 / $3,922.75 / $6,102.08	Professional		$1,527.07	$3,922.75	$6,102.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,638.73 / $2,638.73 / $2,638.73	Professional		$2,638.73	$2,638.73	$2,638.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,384.55 / $4,051.79 / $5,194.39	Professional		$2,384.55	$4,051.79	$5,194.39
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 $863.01 / $1,722.32 / $3,688.18	Professional		$863.01	$1,722.32	$3,688.18