Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $444.16 / $939.15 / $14,482.00	Facility		$444.16	$939.15	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $413.07 / $454.76 / $2,142.00	Professional		$413.07	$454.76	$2,142.00
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 $445.02 / $920.71 / $2,627.02	Professional		$445.02	$920.71	$2,627.02
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 $1,187.68 / $1,387.89 / $2,129.06	Facility		$1,187.68	$1,387.89	$2,129.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $668.22 / $1,824.02 / $2,072.75	Professional		$668.22	$1,824.02	$2,072.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $444.16 / $595.35 / $981.59	Facility		$444.16	$595.35	$981.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $444.16 / $922.84 / $8,103.00	Facility		$444.16	$922.84	$8,103.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $502.02 / $889.28 / $3,395.76	Professional		$502.02	$889.28	$3,395.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $359.43 / $965.00	Professional		$62.75	$359.43	$965.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $444.16 / $595.35 / $981.59	Facility		$444.16	$595.35	$981.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $890.50 / $1,085.04 / $1,619.75	Professional		$890.50	$1,085.04	$1,619.75
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 $827.78 / $2,212.15 / $3,395.76	Professional		$827.78	$2,212.15	$3,395.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,353.38 / $2,293.33 / $2,902.85	Professional		$1,353.38	$2,293.33	$2,902.85
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $493.30 / $895.79 / $1,946.69	Professional		$493.30	$895.79	$1,946.69