Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $903.48 / $1,039.00 / $1,039.00	Facility		$903.48	$1,039.00	$1,039.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $855.11 / $920.52 / $1,502.20	Professional		$855.11	$920.52	$1,502.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,790.97 / $1,970.07 / $3,259.57	Facility		$1,790.97	$1,970.07	$3,259.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,611.87 / $1,665.60 / $2,202.89	Professional		$1,611.87	$1,665.60	$2,202.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,288.42 / $3,832.68 / $3,832.68	Facility		$1,288.42	$3,832.68	$3,832.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,162.20 / $3,702.60 / $7,475.07	Facility		$1,162.20	$3,702.60	$7,475.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $848.41 / $2,595.46 / $3,389.54	Professional		$848.41	$2,595.46	$3,389.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $515.29 / $1,355.22 / $2,059.62	Facility		$515.29	$1,355.22	$2,059.62
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,025.46 / $1,748.01 / $2,149.16	Professional		$1,025.46	$1,748.01	$2,149.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $891.98 / $1,790.97 / $8,339.85	Facility		$891.98	$1,790.97	$8,339.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $782.05 / $938.16 / $1,950.14	Professional		$782.05	$938.16	$1,950.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $596.41	Professional		$50.00	$70.00	$596.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $515.29 / $1,355.22 / $2,059.62	Facility		$515.29	$1,355.22	$2,059.62
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,025.46 / $1,748.01 / $2,149.16	Professional		$1,025.46	$1,748.01	$2,149.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,790.97 / $2,756.24 / $4,789.66	Professional		$1,790.97	$2,756.24	$4,789.66
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,162.20 / $3,497.98 / $8,339.85	Facility		$1,162.20	$3,497.98	$8,339.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $848.41 / $1,162.20 / $9,016.74	Professional		$848.41	$1,162.20	$9,016.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,790.97 / $1,790.97 / $1,790.97	Professional		$1,790.97	$1,790.97	$1,790.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,790.97 / $1,790.97 / $1,790.97	Professional		$1,790.97	$1,790.97	$1,790.97
United Facility/Professional Professional Modifier Low / Median / High Price $665.14 / $893.49 / $1,712.52	Professional		$665.14	$893.49	$1,712.52