Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $830.71 / $3,946.21 / $10,765.44	Facility		$830.71	$3,946.21	$10,765.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $574.99 / $1,810.68 / $6,386.88	Professional		$574.99	$1,810.68	$6,386.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $610.85 / $1,763.59 / $4,007.80	Professional		$610.85	$1,763.59	$4,007.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $619.75 / $915.51 / $915.51	Facility		$619.75	$915.51	$915.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $636.29 / $915.51 / $1,415.11	Professional		$636.29	$915.51	$1,415.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,803.14 / $2,107.11 / $3,398.70	Facility		$1,803.14	$2,107.11	$3,398.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $915.92 / $2,094.10 / $2,834.71	Professional		$915.92	$2,094.10	$2,834.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $737.65 / $999.18 / $2,151.19	Facility		$737.65	$999.18	$2,151.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $737.65 / $3,193.00 / $8,384.00	Facility		$737.65	$3,193.00	$8,384.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $690.38 / $1,944.95 / $4,419.14	Professional		$690.38	$1,944.95	$4,419.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $401.11 / $1,297.75	Professional		$62.75	$401.11	$1,297.75
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $737.65 / $999.18 / $2,151.19	Facility		$737.65	$999.18	$2,151.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,313.65 / $2,021.00 / $2,392.75	Professional		$1,313.65	$2,021.00	$2,392.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,909.30 / $7,909.30 / $7,909.30	Facility		$7,909.30	$7,909.30	$7,909.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $952.38 / $3,113.65 / $5,932.42	Professional		$952.38	$3,113.65	$5,932.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,527.92 / $4,086.88 / $4,086.88	Professional		$1,527.92	$4,086.88	$4,086.88
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $7,611.00 / $9,134.00	Facility		$4,918.00	$7,611.00	$9,134.00
United Facility/Professional Professional Modifier Low / Median / High Price $690.38 / $2,145.34 / $2,783.60	Professional		$690.38	$2,145.34	$2,783.60