Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $646.23 / $1,365.64 / $14,482.00	Facility		$646.23	$1,365.64	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $618.84 / $681.79 / $2,579.54	Professional		$618.84	$681.79	$2,579.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,139.00 / $13,743.77 / $21,606.00	Facility		$8,139.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $632.01 / $1,491.30 / $3,964.82	Professional		$632.01	$1,491.30	$3,964.82
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 $1,728.35 / $2,019.71 / $3,098.29	Facility		$1,728.35	$2,019.71	$3,098.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $976.52 / $2,645.17 / $3,005.88	Professional		$976.52	$2,645.17	$3,005.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $646.23 / $928.51 / $1,460.10	Facility		$646.23	$928.51	$1,460.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $646.23 / $1,346.70 / $11,598.00	Facility		$646.23	$1,346.70	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $717.43 / $1,382.39 / $5,719.42	Professional		$717.43	$1,382.39	$5,719.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $401.29 / $1,306.38	Professional		$66.47	$401.29	$1,306.38
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $646.23 / $928.51 / $1,460.10	Facility		$646.23	$928.51	$1,460.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,325.35 / $1,614.89 / $2,410.71	Professional		$1,325.35	$1,614.89	$2,410.71
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 $1,237.56 / $3,156.15 / $5,719.42	Professional		$1,237.56	$3,156.15	$5,719.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,133.55 / $2,133.55 / $2,133.55	Professional		$2,133.55	$2,133.55	$2,133.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,912.03 / $3,271.12 / $4,209.63	Professional		$1,912.03	$3,271.12	$4,209.63
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $690.03 / $1,267.09 / $2,818.57	Professional		$690.03	$1,267.09	$2,818.57