Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,697.85 / $3,570.68 / $14,482.00	Facility		$1,697.85	$3,570.68	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,654.66 / $1,765.32 / $8,050.91	Professional		$1,654.66	$1,765.32	$8,050.91
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 $1,689.68 / $3,918.11 / $10,487.47	Professional		$1,689.68	$3,918.11	$10,487.47
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 $4,497.49 / $5,255.67 / $8,062.34	Facility		$4,497.49	$5,255.67	$8,062.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,777.20 / $6,922.48 / $7,866.45	Professional		$2,777.20	$6,922.48	$7,866.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,697.85 / $2,311.56 / $3,752.25	Facility		$1,697.85	$2,311.56	$3,752.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,697.85 / $3,502.09 / $7,891.00	Facility		$1,697.85	$3,502.09	$7,891.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,009.42 / $3,789.65 / $16,814.83	Professional		$2,009.42	$3,789.65	$16,814.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $194.79 / $1,060.56 / $3,353.97	Professional		$194.79	$1,060.56	$3,353.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,697.85 / $2,311.56 / $3,752.25	Facility		$1,697.85	$2,311.56	$3,752.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,485.30 / $4,246.70 / $6,339.49	Professional		$3,485.30	$4,246.70	$6,339.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $14,429.87	Facility		$1,722.47	$1,722.47	$14,429.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,238.73 / $8,421.45 / $16,814.83	Professional		$3,238.73	$8,421.45	$16,814.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,625.19 / $5,625.19 / $5,625.19	Professional		$5,625.19	$5,625.19	$5,625.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,842.20 / $8,835.09 / $11,016.70	Professional		$2,842.20	$8,835.09	$11,016.70
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,852.72 / $3,475.57 / $7,663.52	Professional		$1,852.72	$3,475.57	$7,663.52