Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $791.39 / $1,670.81 / $14,482.00	Facility		$791.39	$1,670.81	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $759.08 / $826.06 / $3,701.44	Professional		$759.08	$826.06	$3,701.44
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 $776.37 / $1,826.29 / $4,858.41	Professional		$776.37	$1,826.29	$4,858.41
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 $2,111.32 / $2,467.25 / $3,784.82	Facility		$2,111.32	$2,467.25	$3,784.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,192.91 / $3,236.38 / $3,677.70	Professional		$1,192.91	$3,236.38	$3,677.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $791.39 / $1,157.71 / $1,856.45	Facility		$791.39	$1,157.71	$1,856.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $791.39 / $1,644.77 / $13,250.00	Facility		$791.39	$1,644.77	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $890.00 / $1,695.85 / $6,620.93	Professional		$890.00	$1,695.85	$6,620.93
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 $791.39 / $1,146.51 / $1,856.45	Facility		$791.39	$1,146.51	$1,856.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,625.00 / $1,980.00 / $2,955.75	Professional		$1,625.00	$1,980.00	$2,955.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $19,703.48 / $19,703.48 / $54,390.30	Facility		$19,703.48	$19,703.48	$54,390.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,514.15 / $3,871.80 / $6,620.93	Professional		$1,514.15	$3,871.80	$6,620.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,614.41 / $2,614.41 / $2,614.41	Professional		$2,614.41	$2,614.41	$2,614.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,351.96 / $4,016.57 / $5,150.47	Professional		$2,351.96	$4,016.57	$5,150.47
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 $889.37 / $1,629.06 / $3,523.34	Professional		$889.37	$1,629.06	$3,523.34