Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $892.46 / $1,529.21 / $3,611.69	Facility		$892.46	$1,529.21	$3,611.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $615.08 / $1,177.21 / $3,746.50	Professional		$615.08	$1,177.21	$3,746.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $933.18 / $2,161.09 / $3,539.98	Professional		$933.18	$2,161.09	$3,539.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $761.41 / $1,186.49 / $1,186.49	Facility		$761.41	$1,186.49	$1,186.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $951.28 / $1,485.11 / $2,295.52	Professional		$951.28	$1,485.11	$2,295.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,579.91 / $3,014.82 / $4,862.81	Facility		$2,579.91	$3,014.82	$4,862.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,306.23 / $2,212.33 / $3,337.56	Professional		$1,306.23	$2,212.33	$3,337.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $679.65 / $1,082.63 / $1,936.44	Facility		$679.65	$1,082.63	$1,936.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $649.78 / $1,461.25 / $6,235.00	Facility		$649.78	$1,461.25	$6,235.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $932.71 / $2,298.28 / $5,704.48	Professional		$932.71	$2,298.28	$5,704.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $1,147.29 / $2,409.32	Professional		$85.00	$1,147.29	$2,409.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $679.65 / $1,082.63 / $1,936.44	Facility		$679.65	$1,082.63	$1,936.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,772.61 / $2,448.86 / $3,295.96	Professional		$1,772.61	$2,448.86	$3,295.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,619.51 / $3,619.51 / $3,619.51	Facility		$3,619.51	$3,619.51	$3,619.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,256.02 / $4,177.17 / $7,469.84	Professional		$1,256.02	$4,177.17	$7,469.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,237.94 / $2,331.92 / $3,095.81	Professional		$1,237.94	$2,331.92	$3,095.81
United Facility/Professional Facility Modifier Low / Median / High Price $2,203.00 / $4,316.80 / $19,003.00	Facility		$2,203.00	$4,316.80	$19,003.00
United Facility/Professional Professional Modifier Low / Median / High Price $932.71 / $2,112.82 / $3,394.38	Professional		$932.71	$2,112.82	$3,394.38