Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,332.07 / $2,780.80 / $14,482.00	Facility		$1,332.07	$2,780.80	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,272.13 / $1,368.95 / $6,383.74	Professional		$1,272.13	$1,368.95	$6,383.74
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 $1,347.04 / $3,005.46 / $8,250.90	Professional		$1,347.04	$3,005.46	$8,250.90
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 $3,528.79 / $4,123.67 / $6,325.81	Facility		$3,528.79	$4,123.67	$6,325.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,972.75 / $5,396.67 / $6,132.58	Professional		$1,972.75	$5,396.67	$6,132.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,332.07 / $1,762.84 / $3,089.78	Facility		$1,332.07	$1,762.84	$3,089.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,332.07 / $2,745.16 / $13,250.00	Facility		$1,332.07	$2,745.16	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,412.88 / $2,684.38 / $14,907.82	Professional		$1,412.88	$2,684.38	$14,907.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $802.63 / $2,589.57	Professional		$126.60	$802.63	$2,589.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,332.07 / $1,736.35 / $3,089.78	Facility		$1,332.07	$1,736.35	$3,089.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,681.90 / $3,267.79 / $4,878.17	Professional		$2,681.90	$3,267.79	$4,878.17
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 $2,524.86 / $6,677.55 / $14,907.82	Professional		$2,524.86	$6,677.55	$14,907.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,425.55 / $4,425.55 / $4,425.55	Professional		$4,425.55	$4,425.55	$4,425.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,080.52 / $6,870.62 / $8,588.50	Professional		$4,080.52	$6,870.62	$8,588.50
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 $1,447.19 / $2,671.02 / $6,076.57	Professional		$1,447.19	$2,671.02	$6,076.57