Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,017.78 / $1,342.21 / $5,139.34	Facility		$1,017.78	$1,342.21	$5,139.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,017.78 / $1,342.21 / $5,446.93	Professional		$1,017.78	$1,342.21	$5,446.93
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 $1,368.04 / $2,348.71 / $6,706.75	Professional		$1,368.04	$2,348.71	$6,706.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,051.11 / $2,051.11 / $2,051.11	Facility		$2,051.11	$2,051.11	$2,051.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,603.58 / $4,211.07 / $6,459.88	Facility		$3,603.58	$4,211.07	$6,459.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,615.65 / $4,046.31 / $6,258.93	Professional		$1,615.65	$4,046.31	$6,258.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,017.78 / $1,640.49 / $2,883.67	Facility		$1,017.78	$1,640.49	$2,883.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,067.25 / $2,013.32 / $11,733.00	Facility		$1,067.25	$2,013.32	$11,733.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,631.00 / $3,173.57 / $10,200.08	Professional		$1,631.00	$3,173.57	$10,200.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $127.76 / $809.19 / $2,664.14	Professional		$127.76	$809.19	$2,664.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,017.78 / $1,621.95 / $2,883.67	Facility		$1,017.78	$1,621.95	$2,883.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,277.23 / $3,284.10 / $4,751.24	Professional		$2,277.23	$3,284.10	$4,751.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,371.15 / $1,371.15 / $4,762.46	Facility		$1,371.15	$1,371.15	$4,762.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,217.82 / $5,797.98 / $10,200.08	Professional		$2,217.82	$5,797.98	$10,200.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,378.57 / $3,378.57 / $4,428.68	Professional		$3,378.57	$3,378.57	$4,428.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,297.31 / $6,596.07 / $8,765.41	Professional		$4,297.31	$6,596.07	$8,765.41
United Facility/Professional Facility Modifier Low / Median / High Price $4,981.00 / $11,799.00 / $16,373.00	Facility		$4,981.00	$11,799.00	$16,373.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,588.63 / $2,856.75 / $6,634.61	Professional		$1,588.63	$2,856.75	$6,634.61