Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $411.25 / $1,547.10 / $14,482.00	Facility		$411.25	$1,547.10	$14,482.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $205.63 / $205.63 / $773.55	Facility	52	$205.63	$205.63	$773.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.43 / $449.31 / $1,767.00	Professional		$385.43	$449.31	$1,767.00
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 $413.06 / $949.05 / $2,679.90	Professional		$413.06	$949.05	$2,679.90
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 $1,097.56 / $1,282.58 / $1,967.53	Facility		$1,097.56	$1,282.58	$1,967.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $637.02 / $1,687.36 / $1,917.45	Professional		$637.02	$1,687.36	$1,917.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $411.25 / $594.15 / $964.53	Facility		$411.25	$594.15	$964.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $419.68 / $864.83 / $8,103.00	Facility		$419.68	$864.83	$8,103.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $479.06 / $891.67 / $3,259.28	Professional		$479.06	$891.67	$3,259.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.50 / $296.26 / $917.47	Professional		$56.50	$296.26	$917.47
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $411.25 / $594.15 / $964.53	Facility		$411.25	$594.15	$964.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $830.70 / $1,012.18 / $1,510.98	Professional		$830.70	$1,012.18	$1,510.98
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 Facility Modifier 52 Low / Median / High Price $6,791.96 / $6,791.96 / $6,791.96	Facility	52	$6,791.96	$6,791.96	$6,791.96
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $849.00 / $849.00 / $849.00	Facility	AS	$849.00	$849.00	$849.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $789.44 / $2,057.19 / $3,259.28	Professional		$789.44	$2,057.19	$3,259.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $824.24 / $2,152.59 / $2,685.34	Professional		$824.24	$2,152.59	$2,685.34
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 $465.62 / $835.88 / $1,872.05	Professional		$465.62	$835.88	$1,872.05