Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $596.14 / $1,262.72 / $14,482.00	Facility		$596.14	$1,262.72	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $570.13 / $627.17 / $2,771.35	Professional		$570.13	$627.17	$2,771.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $579.57 / $1,375.72 / $3,654.12	Professional		$579.57	$1,375.72	$3,654.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9,966.82 / $9,966.82 / $9,966.82	Facility		$9,966.82	$9,966.82	$9,966.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,598.59 / $1,868.08 / $2,865.68	Facility		$1,598.59	$1,868.08	$2,865.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $904.39 / $2,443.01 / $2,776.15	Professional		$904.39	$2,443.01	$2,776.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $596.14 / $817.12 / $1,263.82	Facility		$596.14	$817.12	$1,263.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $596.14 / $1,206.59 / $15,090.00	Facility		$596.14	$1,206.59	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $633.01 / $1,168.35 / $4,694.09	Professional		$633.01	$1,168.35	$4,694.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $358.17 / $1,135.19	Professional		$66.47	$358.17	$1,135.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $596.14 / $811.40 / $1,263.82	Facility		$596.14	$811.40	$1,263.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,224.59 / $1,492.13 / $2,227.44	Professional		$1,224.59	$1,492.13	$2,227.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,345.85 / $10,345.85 / $28,559.10	Facility		$10,345.85	$10,345.85	$28,559.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,142.97 / $2,898.90 / $4,694.09	Professional		$1,142.97	$2,898.90	$4,694.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,966.38 / $1,966.38 / $1,966.38	Professional		$1,966.38	$1,966.38	$1,966.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,754.02 / $3,013.66 / $3,887.90	Professional		$1,754.02	$3,013.66	$3,887.90
United Facility/Professional Facility Modifier Low / Median / High Price $7,984.00 / $13,721.00 / $17,327.00	Facility		$7,984.00	$13,721.00	$17,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $637.76 / $1,241.61 / $2,628.81	Professional		$637.76	$1,241.61	$2,628.81