Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.00 / $1,192.50 / $1,772.85	Facility		$954.00	$1,192.50	$1,772.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $636.00 / $759.00 / $954.00	Professional		$636.00	$759.00	$954.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,709.25 / $2,067.00 / $2,186.25	Facility		$1,709.25	$2,067.00	$2,186.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.00 / $645.00 / $3,405.16	Professional		$645.00	$645.00	$3,405.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $655.07 / $1,942.91 / $2,019.30	Facility		$655.07	$1,942.91	$2,019.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,187.92 / $2,556.76 / $3,922.13	Facility		$2,187.92	$2,556.76	$3,922.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $913.56 / $2,140.78 / $2,432.69	Professional		$913.56	$2,140.78	$2,432.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $715.50 / $825.00 / $1,563.01	Facility		$715.50	$825.00	$1,563.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $651.90 / $825.00 / $3,776.25	Facility		$651.90	$825.00	$3,776.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $397.50 / $636.00 / $2,202.15	Professional		$397.50	$636.00	$2,202.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $2,194.19	Professional		$55.00	$85.00	$2,194.19
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $715.50 / $825.00 / $1,563.01	Facility		$715.50	$825.00	$1,563.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,327.32 / $1,895.86 / $2,659.06	Professional		$1,327.32	$1,895.86	$2,659.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,590.00 / $1,590.00 / $3,776.25	Facility		$1,590.00	$1,590.00	$3,776.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $421.35 / $3,975.00 / $3,975.00	Professional		$421.35	$3,975.00	$3,975.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $795.00 / $795.00 / $1,692.99	Professional		$795.00	$795.00	$1,692.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $600.00 / $795.00 / $4,340.70	Professional		$600.00	$795.00	$4,340.70
United Facility/Professional Professional Modifier Low / Median / High Price $397.50 / $477.00 / $1,669.50	Professional		$397.50	$477.00	$1,669.50