Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $10,715.19 / $10,715.19	Facility		$4,677.35	$10,715.19	$10,715.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,090.30 / $4,677.35	Professional		$2,754.23	$3,090.30	$4,677.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,762.47 / $9,549.93 / $9,772.37	Facility		$7,762.47	$9,549.93	$9,772.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,890.45 / $7,244.36 / $21,379.62	Professional		$3,890.45	$7,244.36	$21,379.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $5,888.44 / $9,772.37	Facility		$3,890.45	$5,888.44	$9,772.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,890.45 / $4,265.80 / $5,495.41	Professional		$3,890.45	$4,265.80	$5,495.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,772.37 / $11,748.98 / $18,620.87	Facility		$9,772.37	$11,748.98	$18,620.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $9,772.37 / $11,220.18	Professional		$4,466.84	$9,772.37	$11,220.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,981.07 / $16,218.10 / $24,547.09	Facility		$3,981.07	$16,218.10	$24,547.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $17,378.01 / $17,378.01 / $19,498.45	Professional		$17,378.01	$17,378.01	$19,498.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,548.13 / $5,011.87 / $13,803.84	Facility		$3,548.13	$5,011.87	$13,803.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,344.23 / $19,498.45	Professional		$1,778.28	$2,344.23	$19,498.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $3,630.78	Professional		$50.12	$70.79	$3,630.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,309.57 / $9,120.11 / $12,882.50	Professional		$6,309.57	$9,120.11	$12,882.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,762.47 / $18,620.87 / $18,620.87	Facility		$7,762.47	$18,620.87	$18,620.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,248.07 / $14,454.40 / $19,498.45	Professional		$5,248.07	$14,454.40	$19,498.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8,317.64 / $8,317.64 / $8,317.64	Professional		$8,317.64	$8,317.64	$8,317.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,890.45 / $11,481.54 / $19,498.45	Professional		$3,890.45	$11,481.54	$19,498.45
United Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,162.28	Facility		$3,162.28	$3,162.28	$3,162.28
United Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,344.23 / $6,456.54	Professional		$1,659.59	$2,344.23	$6,456.54