Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,309.16 / $1,649.66 / $6,253.72	Facility		$1,309.16	$1,649.66	$6,253.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,309.16 / $1,649.66 / $6,628.00	Professional		$1,309.16	$1,649.66	$6,628.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $10,038.00	Facility		$2,740.00	$4,780.00	$10,038.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,699.57 / $3,021.15 / $8,632.70	Professional		$1,699.57	$3,021.15	$8,632.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,333.06 / $2,333.06 / $2,333.06	Facility		$2,333.06	$2,333.06	$2,333.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,373.14 / $5,110.35 / $7,839.41	Facility		$4,373.14	$5,110.35	$7,839.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,100.17 / $4,627.99 / $7,615.69	Professional		$2,100.17	$4,627.99	$7,615.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,309.16 / $2,100.94 / $3,508.94	Facility		$1,309.16	$2,100.94	$3,508.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,382.98 / $2,474.48 / $11,733.00	Facility		$1,382.98	$2,474.48	$11,733.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,013.25 / $3,911.00 / $12,434.32	Professional		$2,013.25	$3,911.00	$12,434.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $160.11 / $993.30 / $3,212.90	Professional		$160.11	$993.30	$3,212.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,309.16 / $2,020.63 / $3,508.94	Facility		$1,309.16	$2,020.63	$3,508.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,952.33 / $4,010.00 / $5,772.25	Professional		$2,952.33	$4,010.00	$5,772.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,552.59 / $1,552.59 / $6,070.38	Facility		$1,552.59	$1,552.59	$6,070.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,833.27 / $7,054.83 / $12,434.32	Professional		$2,833.27	$7,054.83	$12,434.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,229.10 / $8,422.44 / $10,665.51	Professional		$5,229.10	$8,422.44	$10,665.51
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 $1,893.92 / $3,690.80 / $7,753.15	Professional		$1,893.92	$3,690.80	$7,753.15