Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $555.62 / $6,211.01 / $17,478.16	Facility		$555.62	$6,211.01	$17,478.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $505.13 / $857.32 / $5,010.30	Professional		$505.13	$857.32	$5,010.30
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 $567.95 / $1,328.01 / $3,236.85	Professional		$567.95	$1,328.01	$3,236.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $574.76 / $689.71 / $862.14	Facility		$574.76	$689.71	$862.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $552.40 / $580.02 / $781.52	Professional		$552.40	$580.02	$781.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,586.87 / $1,854.39 / $2,844.68	Facility		$1,586.87	$1,854.39	$2,844.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $899.35 / $2,343.42 / $2,662.99	Professional		$899.35	$2,343.42	$2,662.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $555.62 / $795.13 / $1,251.70	Facility		$555.62	$795.13	$1,251.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $556.30 / $1,155.00 / $7,791.00	Facility		$556.30	$1,155.00	$7,791.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $618.58 / $1,142.20 / $5,838.31	Professional		$618.58	$1,142.20	$5,838.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $477.96 / $1,262.37	Professional		$62.75	$477.96	$1,262.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $555.62 / $795.13 / $1,251.70	Facility		$555.62	$795.13	$1,251.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,209.00 / $1,473.12 / $2,199.08	Professional		$1,209.00	$1,473.12	$2,199.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,900.50 / $1,900.50 / $5,246.20	Facility		$1,900.50	$1,900.50	$5,246.20
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $497.27 / $497.27 / $497.27	Facility	AS	$497.27	$497.27	$497.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,177.33 / $2,841.30 / $5,838.31	Professional		$1,177.33	$2,841.30	$5,838.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,563.21 / $3,229.39 / $3,509.05	Professional		$1,563.21	$3,229.39	$3,509.05
United Facility/Professional Facility Modifier Low / Median / High Price $4,103.00 / $6,477.00 / $8,384.00	Facility		$4,103.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $618.58 / $1,074.18 / $2,557.17	Professional		$618.58	$1,074.18	$2,557.17