Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,716.37 / $2,095.37 / $7,969.84	Facility		$1,716.37	$2,095.37	$7,969.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,716.37 / $2,095.37 / $8,733.68	Professional		$1,716.37	$2,095.37	$8,733.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $9,948.00 / $15,579.70	Facility		$6,538.00	$9,948.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,213.12 / $3,960.86 / $11,078.36	Professional		$2,213.12	$3,960.86	$11,078.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,916.85 / $2,916.85 / $2,916.85	Facility		$2,916.85	$2,916.85	$2,916.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,573.43 / $6,512.99 / $9,991.09	Facility		$5,573.43	$6,512.99	$9,991.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,671.26 / $6,267.08 / $9,726.24	Professional		$2,671.26	$6,267.08	$9,726.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,716.37 / $2,759.77 / $4,471.85	Facility		$1,716.37	$2,759.77	$4,471.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,804.49 / $3,250.69 / $12,202.00	Facility		$1,804.49	$3,250.69	$12,202.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,600.48 / $5,026.07 / $15,904.32	Professional		$2,600.48	$5,026.07	$15,904.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $191.65 / $1,282.17 / $4,178.50	Professional		$191.65	$1,282.17	$4,178.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,716.37 / $2,697.13 / $4,471.85	Facility		$1,716.37	$2,697.13	$4,471.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,848.44 / $5,131.37 / $7,553.96	Professional		$3,848.44	$5,131.37	$7,553.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,853.01 / $1,853.01 / $8,003.55	Facility		$1,853.01	$1,853.01	$8,003.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,701.35 / $9,135.65 / $15,904.32	Professional		$3,701.35	$9,135.65	$15,904.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,708.49 / $5,708.49 / $6,940.89	Professional		$5,708.49	$5,708.49	$6,940.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $6,866.11 / $11,100.87 / $13,621.34	Professional		$6,866.11	$11,100.87	$13,621.34
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,331.05 / $4,511.64 / $9,963.68	Professional		$2,331.05	$4,511.64	$9,963.68