Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,708.05 / $5,687.69 / $14,482.00	Facility		$2,708.05	$5,687.69	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,611.71 / $2,812.75 / $12,933.30	Professional		$2,611.71	$2,812.75	$12,933.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,718.50 / $5,781.86 / $16,747.09	Professional		$2,718.50	$5,781.86	$16,747.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,560.77 / $7,560.77 / $7,560.77	Facility		$7,560.77	$7,560.77	$7,560.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,148.59 / $8,353.69 / $12,814.77	Facility		$7,148.59	$8,353.69	$12,814.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,864.81 / $11,027.16 / $12,530.86	Professional		$3,864.81	$11,027.16	$12,530.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,708.05 / $3,791.79 / $5,984.79	Facility		$2,708.05	$3,791.79	$5,984.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,708.05 / $5,356.00 / $15,090.00	Facility		$2,708.05	$5,356.00	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,828.87 / $5,438.50 / $20,722.64	Professional		$2,828.87	$5,438.50	$20,722.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $262.55 / $1,677.75 / $5,339.31	Professional		$262.55	$1,677.75	$5,339.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,708.05 / $3,791.27 / $5,984.79	Facility		$2,708.05	$3,791.27	$5,984.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,565.30 / $6,781.10 / $10,122.85	Professional		$5,565.30	$6,781.10	$10,122.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,213.88 / $7,213.88 / $29,598.84	Facility		$7,213.88	$7,213.88	$29,598.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,159.13 / $13,528.60 / $20,722.64	Professional		$5,159.13	$13,528.60	$20,722.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $8,982.70 / $8,982.70 / $8,982.70	Professional		$8,982.70	$8,982.70	$8,982.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,938.70 / $13,852.39 / $17,549.07	Professional		$7,938.70	$13,852.39	$17,549.07
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,090.00	Facility		$8,627.00	$12,373.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,819.30 / $5,058.50 / $12,311.03	Professional		$2,819.30	$5,058.50	$12,311.03