Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,224.67 / $3,004.16 / $14,482.00	Facility		$1,224.67	$3,004.16	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,140.02 / $1,443.92 / $9,553.20	Professional		$1,140.02	$1,443.92	$9,553.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,376.04 / $3,180.94 / $6,529.44	Professional		$1,376.04	$3,180.94	$6,529.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,340.10 / $1,602.22 / $1,802.49	Facility		$1,340.10	$1,602.22	$1,802.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,335.18 / $1,468.70 / $1,919.00	Professional		$1,335.18	$1,468.70	$1,919.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,780.20 / $4,417.46 / $6,776.50	Facility		$3,780.20	$4,417.46	$6,776.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,399.62 / $2,670.36 / $4,240.26	Professional		$1,399.62	$2,670.36	$4,240.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,392.26 / $2,006.66 / $4,331.55	Facility		$1,392.26	$2,006.66	$4,331.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,432.86 / $4,020.30 / $11,598.00	Facility		$1,432.86	$4,020.30	$11,598.00
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $6,576.94 / $6,576.94 / $6,576.94	Facility	62	$6,576.94	$6,576.94	$6,576.94
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $1,052.31 / $1,052.31 / $1,052.31	Facility	AS	$1,052.31	$1,052.31	$1,052.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,440.21 / $2,508.96 / $6,940.07	Professional		$1,440.21	$2,508.96	$6,940.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $125.82 / $877.07 / $2,719.07	Professional		$125.82	$877.07	$2,719.07
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,392.26 / $2,006.66 / $4,331.55	Facility		$1,392.26	$2,006.66	$4,331.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,829.05 / $3,627.31 / $5,147.67	Professional		$2,829.05	$3,627.31	$5,147.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,529.08 / $11,102.00 / $11,102.00	Facility		$7,529.08	$11,102.00	$11,102.00
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $4,705.68 / $6,576.94 / $6,576.94	Facility	62	$4,705.68	$6,576.94	$6,576.94
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $752.91 / $1,052.31 / $1,052.31	Facility	AS	$752.91	$1,052.31	$1,052.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,690.11 / $6,133.46 / $12,056.47	Professional		$1,690.11	$6,133.46	$12,056.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,611.17 / $3,403.78 / $6,204.99	Professional		$2,611.17	$3,403.78	$6,204.99
United Facility/Professional Facility Modifier Low / Median / High Price $6,073.00 / $9,837.00 / $12,062.00	Facility		$6,073.00	$9,837.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,427.40 / $2,352.28 / $5,702.51	Professional		$1,427.40	$2,352.28	$5,702.51