Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,177.42 / $1,531.64 / $5,860.29	Facility		$1,177.42	$1,531.64	$5,860.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,177.42 / $1,531.64 / $6,211.04	Professional		$1,177.42	$1,531.64	$6,211.04
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 $1,581.14 / $2,717.12 / $7,760.97	Professional		$1,581.14	$2,717.12	$7,760.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,306.26 / $2,306.26 / $2,306.26	Facility		$2,306.26	$2,306.26	$2,306.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,106.39 / $4,798.66 / $7,361.26	Facility		$4,106.39	$4,798.66	$7,361.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,930.79 / $4,354.21 / $7,078.50	Professional		$1,930.79	$4,354.21	$7,078.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,177.42 / $1,870.62 / $3,288.20	Facility		$1,177.42	$1,870.62	$3,288.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,235.36 / $2,297.46 / $11,733.00	Facility		$1,235.36	$2,297.46	$11,733.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,868.06 / $3,632.98 / $11,641.28	Professional		$1,868.06	$3,632.98	$11,641.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $127.76 / $932.65 / $3,034.53	Professional		$127.76	$932.65	$3,034.53
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,177.42 / $1,857.65 / $3,288.20	Facility		$1,177.42	$1,857.65	$3,288.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,635.52 / $3,745.17 / $5,447.63	Professional		$2,635.52	$3,745.17	$5,447.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,527.33 / $1,527.33 / $5,504.24	Facility		$1,527.33	$1,527.33	$5,504.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,571.69 / $6,612.93 / $11,641.28	Professional		$2,571.69	$6,612.93	$11,641.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,909.63 / $3,909.63 / $5,055.92	Professional		$3,909.63	$3,909.63	$5,055.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,900.14 / $7,628.69 / $9,997.49	Professional		$4,900.14	$7,628.69	$9,997.49
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,756.35 / $3,376.22 / $7,249.50	Professional		$1,756.35	$3,376.22	$7,249.50