Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,068.74 / $2,258.15 / $14,482.00	Facility		$1,068.74	$2,258.15	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,068.74 / $1,186.61 / $4,024.52	Professional		$1,068.74	$1,186.61	$4,024.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,072.57 / $2,466.32 / $6,323.19	Professional		$1,072.57	$2,466.32	$6,323.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,971.90 / $2,971.90 / $2,971.90	Facility		$2,971.90	$2,971.90	$2,971.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,829.52 / $3,306.51 / $5,072.28	Facility		$2,829.52	$3,306.51	$5,072.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,601.47 / $4,369.04 / $4,964.81	Professional		$1,601.47	$4,369.04	$4,964.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,068.74 / $1,566.53 / $2,509.05	Facility		$1,068.74	$1,566.53	$2,509.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,068.74 / $2,208.39 / $5,639.00	Facility		$1,068.74	$2,208.39	$5,639.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,241.03 / $2,183.69 / $11,189.53	Professional		$1,241.03	$2,183.69	$11,189.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $683.54 / $2,149.11	Professional		$95.64	$683.54	$2,149.11
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,068.74 / $1,557.35 / $2,509.05	Facility		$1,068.74	$1,557.35	$2,509.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,228.85 / $2,715.77 / $4,054.11	Professional		$2,228.85	$2,715.77	$4,054.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,469.60 / $2,469.60 / $7,874.76	Facility		$2,469.60	$2,469.60	$7,874.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,044.09 / $5,321.65 / $11,189.53	Professional		$2,044.09	$5,321.65	$11,189.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,555.94 / $3,555.94 / $3,555.94	Professional		$3,555.94	$3,555.94	$3,555.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,131.65 / $5,488.01 / $6,953.07	Professional		$2,131.65	$5,488.01	$6,953.07
United Facility/Professional Facility Modifier Low / Median / High Price $2,723.00 / $3,912.00 / $5,865.00	Facility		$2,723.00	$3,912.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,209.05 / $2,180.94 / $4,842.70	Professional		$1,209.05	$2,180.94	$4,842.70