Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,006.84 / $2,106.44 / $14,482.00	Facility		$1,006.84	$2,106.44	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $961.49 / $1,006.84 / $4,871.20	Professional		$961.49	$1,006.84	$4,871.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,975.00 / $13,919.00 / $24,485.00	Facility		$5,975.00	$13,919.00	$24,485.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,032.04 / $2,323.48 / $6,474.76	Professional		$1,032.04	$2,323.48	$6,474.76
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 $2,650.19 / $3,096.96 / $4,750.82	Facility		$2,650.19	$3,096.96	$4,750.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,481.37 / $4,076.72 / $4,632.64	Professional		$1,481.37	$4,076.72	$4,632.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,000.11 / $1,444.86 / $2,340.50	Facility		$1,000.11	$1,444.86	$2,340.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,006.84 / $2,106.44 / $13,250.00	Facility		$1,006.84	$2,106.44	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,108.80 / $2,048.35 / $13,778.46	Professional		$1,108.80	$2,048.35	$13,778.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $605.97 / $1,910.01	Professional		$95.64	$605.97	$1,910.01
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,000.11 / $1,425.68 / $2,340.50	Facility		$1,000.11	$1,425.68	$2,340.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,989.65 / $2,424.31 / $3,619.02	Professional		$1,989.65	$2,424.31	$3,619.02
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 $1,964.55 / $5,095.39 / $13,778.46	Professional		$1,964.55	$5,095.39	$13,778.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,343.38 / $3,343.38 / $3,343.38	Professional		$3,343.38	$3,343.38	$3,343.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,968.24 / $5,164.89 / $6,487.90	Professional		$2,968.24	$5,164.89	$6,487.90
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 $1,092.83 / $2,017.88 / $4,636.81	Professional		$1,092.83	$2,017.88	$4,636.81