Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $887.85 / $1,872.07 / $14,482.00	Facility		$887.85	$1,872.07	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $852.58 / $925.48 / $4,181.07	Professional		$852.58	$925.48	$4,181.07
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 $877.20 / $2,048.90 / $5,257.93	Professional		$877.20	$2,048.90	$5,257.93
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 $2,361.84 / $2,759.99 / $4,233.89	Facility		$2,361.84	$2,759.99	$4,233.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,385.54 / $3,626.28 / $4,120.78	Professional		$1,385.54	$3,626.28	$4,120.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $887.85 / $1,331.25 / $2,080.08	Facility		$887.85	$1,331.25	$2,080.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $887.85 / $1,840.79 / $11,598.00	Facility		$887.85	$1,840.79	$11,598.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,006.09 / $1,915.59 / $11,926.99	Professional		$1,006.09	$1,915.59	$11,926.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $556.26 / $1,751.19	Professional		$66.47	$556.26	$1,751.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $887.85 / $1,287.20 / $2,080.08	Facility		$887.85	$1,287.20	$2,080.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,822.60 / $2,220.77 / $3,315.17	Professional		$1,822.60	$2,220.77	$3,315.17
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 $1,696.57 / $4,373.50 / $11,926.99	Professional		$1,696.57	$4,373.50	$11,926.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,935.82 / $2,935.82 / $2,935.82	Professional		$2,935.82	$2,935.82	$2,935.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,662.29 / $4,513.16 / $5,770.99	Professional		$2,662.29	$4,513.16	$5,770.99
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 $1,006.09 / $1,851.46 / $4,080.84	Professional		$1,006.09	$1,851.46	$4,080.84