Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,736.00 / $5,736.00 / $5,736.00	Facility		$5,736.00	$5,736.00	$5,736.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,680.60 / $4,493.20 / $5,736.00	Professional		$3,680.60	$4,493.20	$5,736.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,277.00 / $12,428.00 / $13,145.00	Facility		$10,277.00	$12,428.00	$13,145.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,824.00 / $3,824.00 / $20,473.75	Professional		$3,824.00	$3,824.00	$20,473.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,273.15 / $11,681.87 / $11,681.87	Facility		$7,273.15	$11,681.87	$11,681.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13,154.55 / $15,372.13 / $23,581.24	Facility		$13,154.55	$15,372.13	$23,581.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,657.26 / $12,871.58 / $14,626.80	Professional		$5,657.26	$12,871.58	$14,626.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,680.60 / $5,736.00 / $16,730.00	Facility		$3,680.60	$5,736.00	$16,730.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $4,302.00 / $5,736.00 / $16,730.00	Facility		$4,302.00	$5,736.00	$16,730.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,390.00 / $2,868.00 / $14,740.80	Professional		$2,390.00	$2,868.00	$14,740.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,680.60 / $5,736.00 / $16,730.00	Facility		$3,680.60	$5,736.00	$16,730.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,979.58 / $11,397.50 / $15,985.76	Professional		$7,979.58	$11,397.50	$15,985.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,560.00 / $22,705.00 / $22,705.00	Facility		$9,560.00	$22,705.00	$22,705.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19,120.00 / $23,900.00 / $23,900.00	Professional		$19,120.00	$23,900.00	$23,900.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $10,179.21 / $10,179.21 / $10,179.21	Professional		$10,179.21	$10,179.21	$10,179.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $13,891.70 / $26,098.80 / $26,098.80	Professional		$13,891.70	$26,098.80	$26,098.80
United Facility/Professional Facility Modifier Low / Median / High Price $4,780.00 / $4,780.00 / $4,780.00	Facility		$4,780.00	$4,780.00	$4,780.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,007.60 / $2,868.00 / $8,897.49	Professional		$2,007.60	$2,868.00	$8,897.49