Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,568.00 / $9,152.00 / $9,680.00	Facility		$7,568.00	$9,152.00	$9,680.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.40 / $1,148.40 / $14,080.00	Professional		$1,148.40	$1,148.40	$14,080.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,421.76 / $3,520.00 / $5,356.06	Facility		$2,421.76	$3,520.00	$5,356.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,687.04 / $11,320.07 / $17,365.28	Facility		$9,687.04	$11,320.07	$17,365.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,044.92 / $9,478.66 / $10,771.20	Professional		$4,044.92	$9,478.66	$10,771.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,865.60 / $3,168.00 / $4,505.60	Facility		$1,865.60	$3,168.00	$4,505.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,865.60 / $3,520.00 / $16,720.00	Facility		$1,865.60	$3,520.00	$16,720.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,041.60 / $3,520.00 / $7,392.00	Professional		$2,041.60	$3,520.00	$7,392.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $3,000.80	Professional		$55.00	$85.00	$3,000.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,865.60 / $3,168.00 / $4,505.60	Facility		$1,865.60	$3,168.00	$4,505.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,914.26 / $8,583.71 / $11,970.20	Professional		$3,914.26	$8,583.71	$11,970.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,040.00 / $7,040.00 / $16,720.00	Facility		$7,040.00	$7,040.00	$16,720.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,865.60 / $1,865.60 / $1,865.60	Professional		$1,865.60	$1,865.60	$1,865.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,495.99 / $7,495.99 / $7,495.99	Professional		$7,495.99	$7,495.99	$7,495.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $18,480.00 / $19,219.20 / $19,219.20	Professional		$18,480.00	$19,219.20	$19,219.20
United Facility/Professional Professional Modifier Low / Median / High Price $1,760.00 / $2,816.00 / $7,392.00	Professional		$1,760.00	$2,816.00	$7,392.00