Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,647.60 / $4,647.60 / $4,647.60	Facility		$4,647.60	$4,647.60	$4,647.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,982.21 / $3,640.62 / $4,647.60	Professional		$2,982.21	$3,640.62	$4,647.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,326.95 / $10,069.79 / $10,650.75	Facility		$8,326.95	$10,069.79	$10,650.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,246.40 / $1,246.40 / $15,798.94	Professional		$1,246.40	$1,246.40	$15,798.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,893.03 / $9,465.25 / $9,465.25	Facility		$5,893.03	$9,465.25	$9,465.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,658.45 / $12,455.24 / $19,106.66	Facility		$10,658.45	$12,455.24	$19,106.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,584.00 / $10,429.20 / $11,851.38	Professional		$4,584.00	$10,429.20	$11,851.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,982.21 / $4,647.60 / $13,555.50	Facility		$2,982.21	$4,647.60	$13,555.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,485.70 / $4,647.60 / $13,555.50	Facility		$3,485.70	$4,647.60	$13,555.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,936.50 / $2,323.80 / $11,943.75	Professional		$1,936.50	$2,323.80	$11,943.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,982.21 / $4,647.60 / $13,555.50	Facility		$2,982.21	$4,647.60	$13,555.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,465.42 / $9,234.77 / $12,952.39	Professional		$6,465.42	$9,234.77	$12,952.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,746.00 / $18,396.75 / $18,396.75	Facility		$7,746.00	$18,396.75	$18,396.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15,492.00 / $19,365.00 / $19,365.00	Professional		$15,492.00	$19,365.00	$19,365.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8,247.71 / $8,247.71 / $8,247.71	Professional		$8,247.71	$8,247.71	$8,247.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $11,255.77 / $21,146.58 / $21,146.58	Professional		$11,255.77	$21,146.58	$21,146.58
United Facility/Professional Professional Modifier Low / Median / High Price $1,742.85 / $2,323.80 / $8,133.30	Professional		$1,742.85	$2,323.80	$8,133.30