Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,411.95 / $2,946.31 / $14,482.00	Facility		$1,411.95	$2,946.31	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,386.91 / $1,423.15 / $6,727.04	Professional		$1,386.91	$1,423.15	$6,727.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,293.00 / $10,261.00 / $16,653.39	Facility		$6,293.00	$10,261.00	$16,653.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,414.26 / $3,258.35 / $8,746.59	Professional		$1,414.26	$3,258.35	$8,746.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8,037.49 / $8,037.49 / $8,037.49	Facility		$8,037.49	$8,037.49	$8,037.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,723.43 / $4,351.12 / $6,674.73	Facility		$3,723.43	$4,351.12	$6,674.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,992.72 / $5,711.59 / $6,490.44	Professional		$1,992.72	$5,711.59	$6,490.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,398.96 / $1,976.73 / $3,273.68	Facility		$1,398.96	$1,976.73	$3,273.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,409.76 / $2,946.31 / $13,250.00	Facility		$1,409.76	$2,946.31	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,544.04 / $2,906.58 / $17,154.97	Professional		$1,544.04	$2,906.58	$17,154.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $845.51 / $2,687.63	Professional		$126.60	$845.51	$2,687.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,398.96 / $1,964.21 / $3,273.68	Facility		$1,398.96	$1,964.21	$3,273.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,780.70 / $3,388.18 / $5,057.88	Professional		$2,780.70	$3,388.18	$5,057.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,994.41 / $5,994.41 / $16,547.20	Facility		$5,994.41	$5,994.41	$16,547.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,672.20 / $7,036.65 / $17,154.97	Professional		$2,672.20	$7,036.65	$17,154.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,691.46 / $4,691.46 / $4,691.46	Professional		$4,691.46	$4,691.46	$4,691.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,809.39 / $7,209.93 / $9,089.62	Professional		$4,809.39	$7,209.93	$9,089.62
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 $1,544.04 / $2,824.12 / $6,403.35	Professional		$1,544.04	$2,824.12	$6,403.35