Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $734.39 / $1,553.56 / $14,482.00	Facility		$734.39	$1,553.56	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $695.68 / $768.29 / $2,934.50	Professional		$695.68	$768.29	$2,934.50
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 $716.11 / $1,694.76 / $4,503.84	Professional		$716.11	$1,694.76	$4,503.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,560.77 / $7,560.77 / $7,560.77	Facility		$7,560.77	$7,560.77	$7,560.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,963.54 / $2,294.55 / $3,519.90	Facility		$1,963.54	$2,294.55	$3,519.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,110.69 / $3,006.65 / $3,416.65	Professional		$1,110.69	$3,006.65	$3,416.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $734.39 / $1,062.69 / $2,183.87	Facility		$734.39	$1,062.69	$2,183.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $734.39 / $1,531.57 / $15,090.00	Facility		$734.39	$1,531.57	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $803.26 / $1,573.91 / $6,386.47	Professional		$803.26	$1,573.91	$6,386.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.47 / $445.71 / $1,464.01	Professional		$66.47	$445.71	$1,464.01
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $734.39 / $1,062.69 / $2,183.87	Facility		$734.39	$1,062.69	$2,183.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,509.30 / $1,839.02 / $2,745.30	Professional		$1,509.30	$1,839.02	$2,745.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,745.84 / $9,745.84 / $26,902.80	Facility		$9,745.84	$9,745.84	$26,902.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,406.67 / $3,593.40 / $6,386.47	Professional		$1,406.67	$3,593.40	$6,386.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,423.64 / $2,423.64 / $2,423.64	Professional		$2,423.64	$2,423.64	$2,423.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,362.17 / $3,718.68 / $4,784.89	Professional		$2,362.17	$3,718.68	$4,784.89
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,090.00	Facility		$8,627.00	$12,373.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $785.67 / $1,450.63 / $3,280.77	Professional		$785.67	$1,450.63	$3,280.77