Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $423.08 / $903.51 / $6,461.00	Facility		$423.08	$903.51	$6,461.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $402.19 / $580.10 / $2,197.78	Professional		$402.19	$580.10	$2,197.78
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 $535.96 / $976.34 / $2,584.85	Professional		$535.96	$976.34	$2,584.85
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 $1,569.75 / $1,834.38 / $2,813.98	Facility		$1,569.75	$1,834.38	$2,813.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $646.20 / $1,589.32 / $2,700.14	Professional		$646.20	$1,589.32	$2,700.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $420.00 / $642.50 / $1,215.54	Facility		$420.00	$642.50	$1,215.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $423.08 / $710.80 / $7,160.00	Facility		$423.08	$710.80	$7,160.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $614.83 / $1,300.16 / $4,369.76	Professional		$614.83	$1,300.16	$4,369.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.84 / $335.88 / $1,115.10	Professional		$61.84	$335.88	$1,115.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $420.00 / $634.62 / $1,215.54	Facility		$420.00	$634.62	$1,215.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $948.78 / $1,355.17 / $1,975.22	Professional		$948.78	$1,355.17	$1,975.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,028.88 / $2,028.88 / $3,244.77	Facility		$2,028.88	$2,028.88	$3,244.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $911.03 / $2,501.28 / $4,369.76	Professional		$911.03	$2,501.28	$4,369.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,346.43 / $2,778.09 / $3,781.46	Professional		$1,346.43	$2,778.09	$3,781.46
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 $592.78 / $1,169.06 / $2,629.22	Professional		$592.78	$1,169.06	$2,629.22