Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,260.00 / $1,575.00 / $2,341.50	Facility		$1,260.00	$1,575.00	$2,341.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $840.00 / $987.00 / $1,260.00	Professional		$840.00	$987.00	$1,260.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,257.50 / $2,730.00 / $2,887.50	Facility		$2,257.50	$2,730.00	$2,887.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $420.00 / $724.50 / $4,497.37	Professional		$420.00	$724.50	$4,497.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $948.15 / $2,566.11 / $2,667.00	Facility		$948.15	$2,566.11	$2,667.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,889.89 / $3,377.07 / $5,180.51	Facility		$2,889.89	$3,377.07	$5,180.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,206.36 / $2,827.44 / $3,213.00	Professional		$1,206.36	$2,827.44	$3,213.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $661.50 / $945.00 / $2,064.33	Facility		$661.50	$945.00	$2,064.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $661.50 / $987.00 / $4,987.50	Facility		$661.50	$987.00	$4,987.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $525.00 / $840.00 / $2,908.50	Professional		$525.00	$840.00	$2,908.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $519.75 / $2,898.00	Professional		$55.00	$519.75	$2,898.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $661.50 / $945.00 / $2,064.33	Facility		$661.50	$945.00	$2,064.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,752.84 / $2,503.64 / $3,511.52	Professional		$1,752.84	$2,503.64	$3,511.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,100.00 / $2,100.00 / $4,987.50	Facility		$2,100.00	$2,100.00	$4,987.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $556.50 / $5,250.00 / $5,250.00	Professional		$556.50	$5,250.00	$5,250.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $781.76 / $781.76 / $2,236.02	Professional		$781.76	$781.76	$2,236.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $781.76 / $3,832.96 / $5,733.00	Professional		$781.76	$3,832.96	$5,733.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,050.00 / $1,050.00 / $1,050.00	Facility		$1,050.00	$1,050.00	$1,050.00
United Facility/Professional Professional Modifier Low / Median / High Price $521.17 / $630.00 / $2,188.94	Professional		$521.17	$630.00	$2,188.94