Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,398.83 / $13,803.84	Facility		$1,230.27	$2,398.83	$13,803.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,905.46 / $8,317.64	Professional		$1,202.26	$1,905.46	$8,317.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $7,943.28 / $12,589.25	Facility		$5,011.87	$7,943.28	$12,589.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,818.38 / $6,606.93	Professional		$1,445.44	$2,818.38	$6,606.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility		$1,819.70	$1,819.70	$1,819.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,479.11 / $1,905.46	Professional		$1,348.96	$1,479.11	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $4,466.84 / $7,079.46	Facility		$3,801.89	$4,466.84	$7,079.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $3,162.28 / $4,365.16	Professional		$1,479.11	$3,162.28	$4,365.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $3,981.07 / $5,754.40	Facility		$1,348.96	$3,981.07	$5,754.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $3,630.78 / $4,466.84	Professional		$2,630.27	$3,630.78	$4,466.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $4,265.80 / $11,481.54	Facility		$1,445.44	$4,265.80	$11,481.54
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $6,606.93 / $6,606.93 / $6,606.93	Facility	62	$6,606.93	$6,606.93	$6,606.93
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility	AS	$1,047.13	$1,047.13	$1,047.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,290.87 / $7,079.46	Professional		$1,445.44	$2,290.87	$7,079.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $3,890.45	Professional		$32.36	$33.11	$3,890.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,311.31 / $4,786.30	Professional		$2,344.23	$3,311.31	$4,786.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,585.78 / $11,220.18 / $11,220.18	Facility		$7,585.78	$11,220.18	$11,220.18
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $4,677.35 / $4,677.35 / $6,918.31	Facility	62	$4,677.35	$4,677.35	$6,918.31
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $758.58 / $758.58 / $1,122.02	Facility	AS	$758.58	$758.58	$1,122.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,630.27 / $12,022.64	Professional		$1,479.11	$2,630.27	$12,022.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,388.44 / $6,456.54	Professional		$2,570.40	$3,388.44	$6,456.54
United Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $10,232.93 / $12,589.25	Facility		$6,606.93	$10,232.93	$12,589.25
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,089.30 / $5,370.32	Professional		$1,288.25	$2,089.30	$5,370.32