Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $547.14 / $547.14 / $14,482.00	Facility		$547.14	$547.14	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $547.14 / $592.48 / $849.56	Professional		$547.14	$592.48	$849.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,159.00 / $8,456.00 / $10,914.00	Facility		$6,159.00	$8,456.00	$10,914.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $579.51 / $1,339.27 / $3,279.39	Professional		$579.51	$1,339.27	$3,279.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $709.18 / $828.73 / $1,271.30	Facility		$709.18	$828.73	$1,271.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $547.24 / $1,313.10 / $1,492.16	Professional		$547.24	$1,313.10	$1,492.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $380.59 / $660.49 / $984.85	Facility		$380.59	$660.49	$984.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $405.96 / $815.24 / $11,100.00	Facility		$405.96	$815.24	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $322.75 / $615.05 / $4,441.28	Professional		$322.75	$615.05	$4,441.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $85.00 / $731.34	Professional		$58.40	$85.00	$731.34
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $380.59 / $640.15 / $984.85	Facility		$380.59	$640.15	$984.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,143.34 / $1,450.94 / $2,080.42	Professional		$1,143.34	$1,450.94	$2,080.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,891.56 / $9,891.56 / $9,891.56	Facility		$9,891.56	$9,891.56	$9,891.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,154.52 / $2,875.80 / $4,441.28	Professional		$1,154.52	$2,875.80	$4,441.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,165.07 / $1,165.07 / $1,165.07	Professional		$1,165.07	$1,165.07	$1,165.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $939.51 / $1,998.87 / $1,998.87	Professional		$939.51	$1,998.87	$1,998.87
United Facility/Professional Facility Modifier Low / Median / High Price $6,241.00 / $9,837.00 / $12,062.00	Facility		$6,241.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $317.16 / $611.22 / $1,386.18	Professional		$317.16	$611.22	$1,386.18