Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,544.40 / $1,930.50 / $2,870.01	Facility		$1,544.40	$1,930.50	$2,870.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,029.59 / $1,209.78 / $1,544.40	Professional		$1,029.59	$1,209.78	$1,544.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,767.05 / $3,346.20 / $3,539.25	Facility		$2,767.05	$3,346.20	$3,539.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $514.79 / $888.03 / $5,512.50	Professional		$514.79	$888.03	$5,512.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $968.47 / $3,145.30 / $3,268.98	Facility		$968.47	$3,145.30	$3,268.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,541.40 / $4,138.41 / $6,348.42	Facility		$3,541.40	$4,138.41	$6,348.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,478.95 / $3,465.64 / $3,938.23	Professional		$1,478.95	$3,465.64	$3,938.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $772.20 / $1,287.00 / $2,530.30	Facility		$772.20	$1,287.00	$2,530.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $772.20 / $1,544.40 / $6,113.25	Facility		$772.20	$1,544.40	$6,113.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $643.50 / $1,029.59 / $3,564.99	Professional		$643.50	$1,029.59	$3,564.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $1,287.00	Professional		$55.00	$85.00	$1,287.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $772.20 / $1,287.00 / $2,530.30	Facility		$772.20	$1,287.00	$2,530.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,148.66 / $3,069.00 / $4,304.47	Professional		$2,148.66	$3,069.00	$4,304.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $682.11 / $2,574.00 / $6,113.25	Facility		$682.11	$2,574.00	$6,113.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $682.11 / $6,435.00 / $6,435.00	Professional		$682.11	$6,435.00	$6,435.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,740.72 / $2,740.72 / $2,740.72	Professional		$2,740.72	$2,740.72	$2,740.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,740.30 / $7,027.02 / $7,027.02	Professional		$3,740.30	$7,027.02	$7,027.02
United Facility/Professional Professional Modifier Low / Median / High Price $643.50 / $772.20 / $2,395.62	Professional		$643.50	$772.20	$2,395.62