Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $982.04 / $2,035.96 / $14,482.00	Facility		$982.04	$2,035.96	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $927.75 / $1,057.07 / $4,086.22	Professional		$927.75	$1,057.07	$4,086.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $8,139.00 / $11,136.00	Facility		$5,060.00	$8,139.00	$11,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $975.62 / $2,266.23 / $5,788.88	Professional		$975.62	$2,266.23	$5,788.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,971.90 / $2,971.90 / $2,971.90	Facility		$2,971.90	$2,971.90	$2,971.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,564.59 / $2,996.92 / $4,597.35	Facility		$2,564.59	$2,996.92	$4,597.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,445.61 / $3,954.04 / $4,493.22	Professional		$1,445.61	$3,954.04	$4,493.22
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $982.04 / $1,374.86 / $2,553.30	Facility		$982.04	$1,374.86	$2,553.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $982.04 / $2,035.96 / $5,639.00	Facility		$982.04	$2,035.96	$5,639.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,070.06 / $2,016.00 / $8,600.59	Professional		$1,070.06	$2,016.00	$8,600.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $594.04 / $1,890.39	Professional		$95.64	$594.04	$1,890.39
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $982.04 / $1,374.86 / $2,553.30	Facility		$982.04	$1,374.86	$2,553.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,994.85 / $2,430.65 / $3,628.48	Professional		$1,994.85	$2,430.65	$3,628.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,469.60 / $2,469.60 / $6,817.20	Facility		$2,469.60	$2,469.60	$6,817.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,849.91 / $4,864.55 / $8,600.59	Professional		$1,849.91	$4,864.55	$8,600.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,255.45 / $3,255.45 / $3,255.45	Professional		$3,255.45	$3,255.45	$3,255.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,957.16 / $4,989.39 / $6,292.59	Professional		$2,957.16	$4,989.39	$6,292.59
United Facility/Professional Facility Modifier Low / Median / High Price $2,723.00 / $3,912.00 / $5,865.00	Facility		$2,723.00	$3,912.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,070.06 / $1,959.72 / $4,426.74	Professional		$1,070.06	$1,959.72	$4,426.74