Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,055.63 / $2,335.14 / $14,482.00	Facility		$1,055.63	$2,335.14	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,055.63 / $1,204.27 / $5,155.22	Professional		$1,055.63	$1,204.27	$5,155.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $8,139.00 / $11,136.00	Facility		$5,060.00	$8,139.00	$11,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,085.35 / $2,436.06 / $6,803.23	Professional		$1,085.35	$2,436.06	$6,803.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,462.54 / $3,462.54 / $3,462.54	Facility		$3,462.54	$3,462.54	$3,462.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,937.65 / $3,432.88 / $5,266.12	Facility		$2,937.65	$3,432.88	$5,266.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,658.47 / $4,528.57 / $5,146.10	Professional		$1,658.47	$4,528.57	$5,146.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,037.83 / $1,477.88 / $2,477.56	Facility		$1,037.83	$1,477.88	$2,477.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,055.63 / $2,237.94 / $11,100.00	Facility		$1,055.63	$2,237.94	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,224.65 / $2,272.53 / $8,612.71	Professional		$1,224.65	$2,272.53	$8,612.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $128.88 / $718.90 / $2,319.65	Professional		$128.88	$718.90	$2,319.65
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,037.83 / $1,468.05 / $2,477.56	Facility		$1,037.83	$1,468.05	$2,477.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,410.85 / $2,937.53 / $4,385.14	Professional		$2,410.85	$2,937.53	$4,385.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,244.77 / $3,244.77 / $9,800.62	Facility		$3,244.77	$3,244.77	$9,800.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,118.71 / $5,392.50 / $8,612.71	Professional		$2,118.71	$5,392.50	$8,612.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,649.08 / $3,649.08 / $3,649.08	Professional		$3,649.08	$3,649.08	$3,649.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,126.42 / $5,589.94 / $7,206.96	Professional		$3,126.42	$5,589.94	$7,206.96
United Facility/Professional Facility Modifier Low / Median / High Price $4,240.00 / $9,158.00 / $12,062.00	Facility		$4,240.00	$9,158.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,224.39 / $2,272.53 / $4,907.18	Professional		$1,224.39	$2,272.53	$4,907.18