Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,090.39 / $3,090.39 / $3,090.39	Facility		$3,090.39	$3,090.39	$3,090.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,103.45 / $3,166.32 / $5,023.97	Professional		$1,103.45	$3,166.32	$5,023.97
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 $2,971.09 / $5,959.36 / $18,475.05	Professional		$2,971.09	$5,959.36	$18,475.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,669.32 / $2,669.32 / $2,669.32	Facility		$2,669.32	$2,669.32	$2,669.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,209.13 / $4,918.70 / $7,545.42	Facility		$4,209.13	$4,918.70	$7,545.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,175.35 / $12,037.89 / $13,679.43	Professional		$3,175.35	$12,037.89	$13,679.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,090.39 / $4,635.59 / $8,063.68	Facility		$3,090.39	$4,635.59	$8,063.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,096.32 / $6,551.63 / $13,250.00	Facility		$3,096.32	$6,551.63	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,275.32 / $5,722.83 / $25,045.36	Professional		$2,275.32	$5,722.83	$25,045.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $10,574.66	Professional		$50.00	$70.00	$10,574.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,090.39 / $4,635.59 / $8,063.68	Facility		$3,090.39	$4,635.59	$8,063.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,956.91 / $10,212.59 / $14,702.61	Professional		$6,956.91	$10,212.59	$14,702.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,865.24 / $2,865.24 / $19,599.37	Facility		$2,865.24	$2,865.24	$19,599.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,260.22 / $14,883.70 / $25,045.36	Professional		$6,260.22	$14,883.70	$25,045.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,234.78 / $1,234.78 / $1,423.63	Professional		$1,234.78	$1,234.78	$1,423.63
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 $2,488.19 / $5,886.14 / $13,200.11	Professional		$2,488.19	$5,886.14	$13,200.11