Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $973.90 / $2,035.98 / $14,482.00	Facility		$973.90	$2,035.98	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $936.34 / $1,029.68 / $4,602.38	Professional		$936.34	$1,029.68	$4,602.38
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 $968.78 / $2,247.46 / $6,002.22	Professional		$968.78	$2,247.46	$6,002.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,971.90 / $2,971.90 / $2,971.90	Facility		$2,971.90	$2,971.90	$2,971.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,575.40 / $3,009.56 / $4,616.74	Facility		$2,575.40	$3,009.56	$4,616.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,516.94 / $3,962.16 / $4,502.45	Professional		$1,516.94	$3,962.16	$4,502.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $973.90 / $1,341.28 / $2,152.32	Facility		$973.90	$1,341.28	$2,152.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $973.90 / $2,035.98 / $8,103.00	Facility		$973.90	$2,035.98	$8,103.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,147.22 / $1,966.08 / $7,420.16	Professional		$1,147.22	$1,966.08	$7,420.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $591.57 / $1,870.86	Professional		$95.64	$591.57	$1,870.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $973.90 / $1,341.28 / $2,152.32	Facility		$973.90	$1,341.28	$2,152.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,976.65 / $2,408.46 / $3,595.37	Professional		$1,976.65	$2,408.46	$3,595.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,469.60 / $2,469.60 / $7,053.06	Facility		$2,469.60	$2,469.60	$7,053.06
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $646.16 / $646.16 / $646.16	Facility	AS	$646.16	$646.16	$646.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,798.11 / $4,814.20 / $7,420.16	Professional		$1,798.11	$4,814.20	$7,420.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,966.77 / $5,026.55 / $6,305.52	Professional		$2,966.77	$5,026.55	$6,305.52
United Facility/Professional Facility Modifier Low / Median / High Price $4,103.00 / $6,477.00 / $8,384.00	Facility		$4,103.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,105.42 / $1,969.70 / $4,380.92	Professional		$1,105.42	$1,969.70	$4,380.92