Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $754.88 / $1,595.32 / $14,482.00	Facility		$754.88	$1,595.32	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $723.45 / $788.56 / $3,540.02	Professional		$723.45	$788.56	$3,540.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $12,444.00	Facility		$5,169.00	$8,408.00	$12,444.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $742.49 / $1,742.03 / $4,430.60	Professional		$742.49	$1,742.03	$4,430.60
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 $2,015.81 / $2,355.63 / $3,613.59	Facility		$2,015.81	$2,355.63	$3,613.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,140.45 / $3,077.79 / $3,509.49	Professional		$1,140.45	$3,077.79	$3,509.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $754.88 / $1,132.32 / $1,772.58	Facility		$754.88	$1,132.32	$1,772.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $754.88 / $1,566.84 / $13,120.00	Facility		$754.88	$1,566.84	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $775.63 / $1,605.01 / $8,062.34	Professional		$775.63	$1,605.01	$8,062.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $462.45 / $1,507.24	Professional		$66.47	$462.45	$1,507.24
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $754.88 / $1,093.39 / $1,772.58	Facility		$754.88	$1,093.39	$1,772.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,549.60 / $1,888.13 / $2,818.60	Professional		$1,549.60	$1,888.13	$2,818.60
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 $1,444.90 / $3,702.95 / $8,062.34	Professional		$1,444.90	$3,702.95	$8,062.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,491.60 / $2,491.60 / $2,491.60	Professional		$2,491.60	$2,491.60	$2,491.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,217.09 / $3,827.57 / $4,914.92	Professional		$2,217.09	$3,827.57	$4,914.92
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 $770.48 / $1,573.84 / $3,306.88	Professional		$770.48	$1,573.84	$3,306.88