Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.10 / $945.59 / $14,482.00	Facility		$446.10	$945.59	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $367.81 / $459.64 / $1,805.24	Professional		$367.81	$459.64	$1,805.24
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 $429.44 / $1,029.47 / $2,608.09	Professional		$429.44	$1,029.47	$2,608.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,462.54 / $3,462.54 / $3,462.54	Facility		$3,462.54	$3,462.54	$3,462.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,200.29 / $1,402.64 / $2,151.67	Facility		$1,200.29	$1,402.64	$2,151.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $673.82 / $1,765.09 / $2,079.75	Professional		$673.82	$1,765.09	$2,079.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $446.10 / $628.00 / $945.73	Facility		$446.10	$628.00	$945.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $446.10 / $895.55 / $11,100.00	Facility		$446.10	$895.55	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $461.11 / $943.58 / $4,432.64	Professional		$461.11	$943.58	$4,432.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.81 / $265.56 / $837.48	Professional		$61.81	$265.56	$837.48
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $446.10 / $628.00 / $945.73	Facility		$446.10	$628.00	$945.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $914.55 / $1,114.33 / $1,663.50	Professional		$914.55	$1,114.33	$1,663.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,244.77 / $3,244.77 / $8,957.00	Facility		$3,244.77	$3,244.77	$8,957.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $856.27 / $2,149.10 / $4,432.64	Professional		$856.27	$2,149.10	$4,432.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,466.71 / $1,466.71 / $1,466.71	Professional		$1,466.71	$1,466.71	$1,466.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,087.74 / $2,245.37 / $2,912.67	Professional		$1,087.74	$2,245.37	$2,912.67
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 $468.08 / $941.31 / $2,062.41	Professional		$468.08	$941.31	$2,062.41