Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,265.77 / $1,558.73 / $5,913.79	Facility		$1,265.77	$1,558.73	$5,913.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,265.77 / $1,591.90 / $6,314.82	Professional		$1,265.77	$1,591.90	$6,314.82
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 $1,643.92 / $2,921.01 / $8,165.64	Professional		$1,643.92	$2,921.01	$8,165.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,183.17 / $2,183.17 / $2,183.17	Facility		$2,183.17	$2,183.17	$2,183.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,141.55 / $4,839.72 / $7,424.26	Facility		$4,141.55	$4,839.72	$7,424.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,982.32 / $4,660.18 / $7,224.40	Professional		$1,982.32	$4,660.18	$7,224.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,265.77 / $2,028.60 / $3,318.21	Facility		$1,265.77	$2,028.60	$3,318.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,331.18 / $2,402.26 / $11,733.00	Facility		$1,331.18	$2,402.26	$11,733.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,934.22 / $3,740.17 / $11,810.40	Professional		$1,934.22	$3,740.17	$11,810.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $127.76 / $944.37 / $3,088.87	Professional		$127.76	$944.37	$3,088.87
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,265.77 / $1,988.95 / $3,318.21	Facility		$1,265.77	$1,988.95	$3,318.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,837.68 / $3,807.94 / $5,603.15	Professional		$2,837.68	$3,807.94	$5,603.15
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,383.77 / $1,383.77 / $5,903.87	Facility		$1,383.77	$1,383.77	$5,903.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,730.26 / $6,738.45 / $11,810.40	Professional		$2,730.26	$6,738.45	$11,810.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,209.77 / $4,209.77 / $5,169.30	Professional		$4,209.77	$4,209.77	$5,169.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,991.25 / $8,182.18 / $10,117.54	Professional		$4,991.25	$8,182.18	$10,117.54
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 $1,805.65 / $3,388.16 / $7,438.94	Professional		$1,805.65	$3,388.16	$7,438.94