Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $566.41 / $1,197.20 / $14,482.00	Facility		$566.41	$1,197.20	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $540.59 / $632.19 / $2,528.00	Professional		$540.59	$632.19	$2,528.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $569.16 / $1,307.10 / $3,649.92	Professional		$569.16	$1,307.10	$3,649.92
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 $1,510.28 / $1,764.88 / $2,707.37	Facility		$1,510.28	$1,764.88	$2,707.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $876.59 / $2,323.07 / $2,639.85	Professional		$876.59	$2,323.07	$2,639.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $559.62 / $792.97 / $1,330.23	Facility		$559.62	$792.97	$1,330.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $566.41 / $1,153.79 / $8,296.28	Facility		$566.41	$1,153.79	$8,296.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $645.10 / $1,228.60 / $4,399.59	Professional		$645.10	$1,228.60	$4,399.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.81 / $341.61 / $1,089.62	Professional		$61.81	$341.61	$1,089.62
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $559.62 / $792.97 / $1,330.23	Facility		$559.62	$792.97	$1,330.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,128.40 / $1,374.91 / $2,052.46	Professional		$1,128.40	$1,374.91	$2,052.46
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 $1,086.85 / $2,834.55 / $4,399.59	Professional		$1,086.85	$2,834.55	$4,399.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $824.24 / $2,892.96 / $3,697.02	Professional		$824.24	$2,892.96	$3,697.02
United Facility/Professional Facility Modifier Low / Median / High Price $4,103.00 / $6,477.00 / $8,384.00	Facility		$4,103.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $622.00 / $1,147.08 / $2,579.44	Professional		$622.00	$1,147.08	$2,579.44