Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,178.73 / $13,189.45 / $22,110.37	Facility		$1,178.73	$13,189.45	$22,110.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $577.65 / $929.98 / $3,608.73	Professional		$577.65	$929.98	$3,608.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,812.00 / $11,549.00 / $23,967.00	Facility		$6,812.00	$11,549.00	$23,967.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $729.99 / $1,706.00 / $4,489.72	Professional		$729.99	$1,706.00	$4,489.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $541.05 / $813.62 / $813.62	Facility		$541.05	$813.62	$813.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $702.45 / $1,018.98 / $1,575.03	Professional		$702.45	$1,018.98	$1,575.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,954.53 / $2,284.02 / $3,684.05	Facility		$1,954.53	$2,284.02	$3,684.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $858.64 / $1,789.14 / $2,705.72	Professional		$858.64	$1,789.14	$2,705.72
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $577.65 / $834.84 / $2,460.94	Facility		$577.65	$834.84	$2,460.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $629.40 / $1,453.12 / $14,270.00	Facility		$629.40	$1,453.12	$14,270.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $21,407.63 / $21,407.63 / $21,407.63	Facility	50	$21,407.63	$21,407.63	$21,407.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $889.77 / $2,358.17 / $5,000.00	Professional		$889.77	$2,358.17	$5,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.30 / $623.73 / $1,603.82	Professional		$63.30	$623.73	$1,603.82
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $577.65 / $865.11 / $2,460.94	Facility		$577.65	$865.11	$2,460.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,261.19 / $1,774.71 / $2,619.98	Professional		$1,261.19	$1,774.71	$2,619.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,020.36 / $4,020.36 / $4,020.36	Facility		$4,020.36	$4,020.36	$4,020.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $797.30 / $3,140.51 / $7,060.12	Professional		$797.30	$3,140.51	$7,060.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,425.11 / $7,891.45 / $7,891.45	Professional		$3,425.11	$7,891.45	$7,891.45
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 $847.27 / $2,173.44 / $3,580.48	Professional		$847.27	$2,173.44	$3,580.48