Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,076.40 / $1,345.50 / $2,000.31	Facility		$1,076.40	$1,345.50	$2,000.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $457.77 / $843.18 / $1,231.84	Professional		$457.77	$843.18	$1,231.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,928.55 / $2,332.19 / $2,466.75	Facility		$1,928.55	$2,332.19	$2,466.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $358.80 / $618.92 / $3,842.04	Professional		$358.80	$618.92	$3,842.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $809.99 / $2,192.19 / $2,278.38	Facility		$809.99	$2,192.19	$2,278.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,468.17 / $2,884.25 / $4,424.51	Facility		$2,468.17	$2,884.25	$4,424.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,030.84 / $2,415.44 / $2,744.83	Professional		$1,030.84	$2,415.44	$2,744.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $448.50 / $807.30 / $1,763.53	Facility		$448.50	$807.30	$1,763.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $448.50 / $843.18 / $4,260.75	Facility		$448.50	$843.18	$4,260.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $448.50 / $717.60 / $2,484.69	Professional		$448.50	$717.60	$2,484.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $897.00	Professional		$55.00	$85.00	$897.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $448.50 / $807.30 / $1,763.53	Facility		$448.50	$807.30	$1,763.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,497.42 / $2,138.81 / $2,999.83	Professional		$1,497.42	$2,138.81	$2,999.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,794.00 / $1,794.00 / $4,260.75	Facility		$1,794.00	$1,794.00	$4,260.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $475.41 / $4,485.00 / $4,485.00	Professional		$475.41	$4,485.00	$4,485.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,910.20 / $1,910.20 / $1,910.20	Professional		$1,910.20	$1,910.20	$1,910.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,606.87 / $4,897.62 / $4,897.62	Professional		$2,606.87	$4,897.62	$4,897.62
United Facility/Professional Professional Modifier Low / Median / High Price $403.65 / $538.20 / $1,669.68	Professional		$403.65	$538.20	$1,669.68