Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $957.88 / $2,021.35 / $14,482.00	Facility		$957.88	$2,021.35	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $920.01 / $999.47 / $4,504.91	Professional		$920.01	$999.47	$4,504.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $15,141.00 / $22,609.00	Facility		$10,878.00	$15,141.00	$22,609.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $947.48 / $2,210.50 / $5,884.72	Professional		$947.48	$2,210.50	$5,884.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20,692.62 / $20,692.62 / $20,692.62	Facility		$20,692.62	$20,692.62	$20,692.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,548.37 / $2,977.97 / $4,568.28	Facility		$2,548.37	$2,977.97	$4,568.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,500.39 / $3,913.13 / $4,446.74	Professional		$1,500.39	$3,913.13	$4,446.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $957.88 / $1,347.57 / $2,116.91	Facility		$957.88	$1,347.57	$2,116.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $957.88 / $1,931.52 / $15,090.00	Facility		$957.88	$1,931.52	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,086.57 / $2,063.96 / $7,323.92	Professional		$1,086.57	$2,063.96	$7,323.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $588.03 / $1,857.67	Professional		$66.47	$588.03	$1,857.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $957.88 / $1,341.03 / $2,116.91	Facility		$957.88	$1,341.03	$2,116.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,968.85 / $2,398.96 / $3,581.19	Professional		$1,968.85	$2,398.96	$3,581.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $22,272.94 / $22,272.94 / $61,483.10	Facility		$22,272.94	$22,272.94	$61,483.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,830.77 / $4,712.25 / $7,323.92	Professional		$1,830.77	$4,712.25	$7,323.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,166.70 / $3,166.70 / $3,166.70	Professional		$3,166.70	$3,166.70	$3,166.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,870.66 / $4,851.89 / $6,227.51	Professional		$2,870.66	$4,851.89	$6,227.51
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $11,891.00 / $15,090.00	Facility		$8,627.00	$11,891.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,068.89 / $1,920.22 / $4,574.27	Professional		$1,068.89	$1,920.22	$4,574.27