Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,097.92 / $2,307.65 / $14,482.00	Facility		$1,097.92	$2,307.65	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,055.29 / $1,168.78 / $5,193.47	Professional		$1,055.29	$1,168.78	$5,193.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,082.39 / $2,533.66 / $7,048.88	Professional		$1,082.39	$2,533.66	$7,048.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,560.77 / $7,560.77 / $7,560.77	Facility		$7,560.77	$7,560.77	$7,560.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,917.83 / $3,409.71 / $5,230.58	Facility		$2,917.83	$3,409.71	$5,230.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,663.63 / $4,484.84 / $5,096.41	Professional		$1,663.63	$4,484.84	$5,096.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,025.61 / $1,434.93 / $2,426.40	Facility		$1,025.61	$1,434.93	$2,426.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,091.57 / $2,266.14 / $13,250.00	Facility		$1,091.57	$2,266.14	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,250.13 / $2,197.13 / $8,602.26	Professional		$1,250.13	$2,197.13	$8,602.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $671.43 / $2,132.31	Professional		$95.64	$671.43	$2,132.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,025.61 / $1,434.93 / $2,426.40	Facility		$1,025.61	$1,434.93	$2,426.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,248.35 / $2,739.53 / $4,089.58	Professional		$2,248.35	$2,739.53	$4,089.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,213.88 / $7,213.88 / $19,913.50	Facility		$7,213.88	$7,213.88	$19,913.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,098.25 / $5,432.50 / $8,602.26	Professional		$2,098.25	$5,432.50	$8,602.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,627.15 / $3,627.15 / $3,627.15	Professional		$3,627.15	$3,627.15	$3,627.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,961.12 / $5,555.50 / $7,137.31	Professional		$1,961.12	$5,555.50	$7,137.31
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $16,437.00	Facility		$5,266.00	$11,608.00	$16,437.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,250.13 / $2,151.46 / $4,943.58	Professional		$1,250.13	$2,151.46	$4,943.58