Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $578.17 / $3,946.68 / $10,277.27	Facility		$578.17	$3,946.68	$10,277.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.85 / $748.58 / $2,942.00	Professional		$297.85	$748.58	$2,942.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $14,586.00	Facility		$5,169.00	$8,408.00	$14,586.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $596.05 / $1,235.57 / $3,544.33	Professional		$596.05	$1,235.57	$3,544.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $564.52 / $711.98 / $3,462.54	Facility		$564.52	$711.98	$3,462.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $540.12 / $567.13 / $768.60	Professional		$540.12	$567.13	$768.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,545.42 / $1,805.95 / $2,770.37	Facility		$1,545.42	$1,805.95	$2,770.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $913.97 / $2,365.64 / $2,688.23	Professional		$913.97	$2,365.64	$2,688.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $578.17 / $867.27 / $1,585.70	Facility		$578.17	$867.27	$1,585.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $593.40 / $1,233.79 / $13,982.00	Facility		$593.40	$1,233.79	$13,982.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $689.90 / $1,311.50 / $4,528.97	Professional		$689.90	$1,311.50	$4,528.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.66 / $360.37 / $1,146.06	Professional		$65.66	$360.37	$1,146.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $578.17 / $867.27 / $1,585.70	Facility		$578.17	$867.27	$1,585.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,181.05 / $1,439.06 / $2,148.23	Professional		$1,181.05	$1,439.06	$2,148.23
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 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 $1,106.78 / $2,994.30 / $4,528.97	Professional		$1,106.78	$2,994.30	$4,528.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,005.22 / $3,062.74 / $3,764.79	Professional		$2,005.22	$3,062.74	$3,764.79
United Facility/Professional Facility Modifier Low / Median / High Price $6,154.00 / $11,891.00 / $15,090.00	Facility		$6,154.00	$11,891.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $670.42 / $1,190.98 / $2,724.81	Professional		$670.42	$1,190.98	$2,724.81