Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,558.58 / $3,253.14 / $14,482.00	Facility		$1,558.58	$3,253.14	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,499.24 / $1,601.85 / $7,464.69	Professional		$1,499.24	$1,601.85	$7,464.69
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 $1,574.69 / $3,596.72 / $9,614.83	Professional		$1,574.69	$3,596.72	$9,614.83
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 $4,131.64 / $4,828.14 / $7,406.49	Facility		$4,131.64	$4,828.14	$7,406.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,305.21 / $6,313.40 / $7,174.31	Professional		$2,305.21	$6,313.40	$7,174.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,558.58 / $2,061.67 / $3,614.60	Facility		$1,558.58	$2,061.67	$3,614.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,558.58 / $3,237.58 / $13,250.00	Facility		$1,558.58	$3,237.58	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,717.76 / $3,138.92 / $23,959.18	Professional		$1,717.76	$3,138.92	$23,959.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $949.12 / $3,076.57	Professional		$126.60	$949.12	$3,076.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,558.58 / $2,016.72 / $3,614.60	Facility		$1,558.58	$2,016.72	$3,614.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,136.25 / $3,821.40 / $5,704.60	Professional		$3,136.25	$3,821.40	$5,704.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,076.08 / $10,076.08 / $27,814.40	Facility		$10,076.08	$10,076.08	$27,814.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,953.76 / $7,808.25 / $23,959.18	Professional		$2,953.76	$7,808.25	$23,959.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,173.97 / $5,173.97 / $5,173.97	Professional		$5,173.97	$5,173.97	$5,173.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,225.49 / $8,175.29 / $10,047.36	Professional		$5,225.49	$8,175.29	$10,047.36
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 $1,692.24 / $3,116.66 / $7,105.51	Professional		$1,692.24	$3,116.66	$7,105.51