Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,007.59 / $2,088.21 / $14,482.00	Facility		$1,007.59	$2,088.21	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,007.59 / $1,029.83 / $5,142.04	Professional		$1,007.59	$1,029.83	$5,142.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,538.00 / $9,948.00 / $15,579.70	Facility		$6,538.00	$9,948.00	$15,579.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,110.08 / $2,325.21 / $6,427.76	Professional		$1,110.08	$2,325.21	$6,427.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,995.29 / $5,995.29 / $5,995.29	Facility		$5,995.29	$5,995.29	$5,995.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,631.27 / $3,074.85 / $4,716.89	Facility		$2,631.27	$3,074.85	$4,716.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,558.13 / $4,040.39 / $4,591.35	Professional		$1,558.13	$4,040.39	$4,591.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,007.59 / $1,484.96 / $2,295.57	Facility		$1,007.59	$1,484.96	$2,295.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,007.59 / $2,052.82 / $8,384.00	Facility		$1,007.59	$2,052.82	$8,384.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,210.48 / $2,278.78 / $7,521.36	Professional		$1,210.48	$2,278.78	$7,521.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $602.15 / $1,886.52	Professional		$95.64	$602.15	$1,886.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,007.59 / $1,428.44 / $2,295.57	Facility		$1,007.59	$1,428.44	$2,295.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,978.60 / $2,410.85 / $3,598.92	Professional		$1,978.60	$2,410.85	$3,598.92
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 $1,890.32 / $5,378.70 / $7,521.36	Professional		$1,890.32	$5,378.70	$7,521.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,700.09 / $5,742.37 / $6,430.01	Professional		$2,700.09	$5,742.37	$6,430.01
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,176.49 / $2,194.51 / $4,894.62	Professional		$1,176.49	$2,194.51	$4,894.62