Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,662.45 / $3,354.17 / $14,482.00	Facility		$1,662.45	$3,354.17	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,582.30 / $1,662.45 / $7,665.83	Professional		$1,582.30	$1,662.45	$7,665.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,466.00 / $15,738.00 / $23,778.77	Facility		$9,466.00	$15,738.00	$23,778.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,633.78 / $3,836.42 / $9,820.36	Professional		$1,633.78	$3,836.42	$9,820.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33,189.18 / $33,189.18 / $33,189.18	Facility		$33,189.18	$33,189.18	$33,189.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,403.77 / $5,146.16 / $7,894.34	Facility		$4,403.77	$5,146.16	$7,894.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,298.46 / $6,742.29 / $7,661.69	Professional		$2,298.46	$6,742.29	$7,661.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,620.95 / $2,287.29 / $3,726.85	Facility		$1,620.95	$2,287.29	$3,726.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,644.10 / $3,302.01 / $13,250.00	Facility		$1,644.10	$3,302.01	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,783.30 / $3,326.86 / $16,304.65	Professional		$1,783.30	$3,326.86	$16,304.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $981.73 / $3,054.30	Professional		$126.60	$981.73	$3,054.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,620.95 / $2,236.11 / $3,726.85	Facility		$1,620.95	$2,236.11	$3,726.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,166.15 / $3,857.83 / $5,758.98	Professional		$3,166.15	$3,857.83	$5,758.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $28,601.00 / $28,601.00 / $78,951.35	Facility		$28,601.00	$28,601.00	$78,951.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,154.42 / $8,018.65 / $16,304.65	Professional		$3,154.42	$8,018.65	$16,304.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,267.38 / $5,267.38 / $5,267.38	Professional		$5,267.38	$5,267.38	$5,267.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,998.45 / $8,217.95 / $10,729.97	Professional		$4,998.45	$8,217.95	$10,729.97
United Facility/Professional Facility Modifier Low / Median / High Price $7,217.00 / $11,799.00 / $16,373.00	Facility		$7,217.00	$11,799.00	$16,373.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,771.76 / $3,326.86 / $7,296.97	Professional		$1,771.76	$3,326.86	$7,296.97