Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,837.19 / $3,534.07 / $14,482.00	Facility		$1,837.19	$3,534.07	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,746.00 / $1,951.66 / $9,460.86	Professional		$1,746.00	$1,951.66	$9,460.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $7,344.00	Facility		$2,740.00	$4,780.00	$7,344.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,031.33 / $4,239.66 / $11,856.00	Professional		$2,031.33	$4,239.66	$11,856.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,942.50 / $1,942.50 / $1,942.50	Facility		$1,942.50	$1,942.50	$1,942.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,902.99 / $5,729.54 / $8,789.26	Facility		$4,902.99	$5,729.54	$8,789.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,543.19 / $7,228.46 / $8,214.16	Professional		$2,543.19	$7,228.46	$8,214.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,610.37 / $2,415.48 / $3,926.75	Facility		$1,610.37	$2,415.48	$3,926.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,749.96 / $2,843.86 / $4,776.68	Facility		$1,749.96	$2,843.86	$4,776.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,638.50 / $3,958.52 / $13,034.08	Professional		$1,638.50	$3,958.52	$13,034.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $940.31 / $1,728.85 / $4,062.81	Professional		$940.31	$1,728.85	$4,062.81
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,610.37 / $2,415.48 / $3,926.75	Facility		$1,610.37	$2,415.48	$3,926.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,297.37 / $4,061.82 / $6,612.86	Professional		$3,297.37	$4,061.82	$6,612.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $10,434.35	Facility		$1,722.47	$1,722.47	$10,434.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,280.42 / $9,896.29 / $13,034.08	Professional		$3,280.42	$9,896.29	$13,034.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,315.53 / $6,315.53 / $6,315.53	Professional		$6,315.53	$6,315.53	$6,315.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,839.57 / $10,764.75 / $11,503.66	Professional		$5,839.57	$10,764.75	$11,503.66
United Facility/Professional Facility Modifier Low / Median / High Price $2,367.00 / $3,088.30 / $4,295.00	Facility		$2,367.00	$3,088.30	$4,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,739.03 / $3,546.78 / $8,837.79	Professional		$1,739.03	$3,546.78	$8,837.79