Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,051.75 / $2,214.73 / $14,482.00	Facility		$1,051.75	$2,214.73	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,010.53 / $1,119.70 / $4,183.39	Professional		$1,010.53	$1,119.70	$4,183.39
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 $1,036.48 / $2,427.11 / $6,467.73	Professional		$1,036.48	$2,427.11	$6,467.73
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 $2,794.37 / $3,265.45 / $5,009.28	Facility		$2,794.37	$3,265.45	$5,009.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,620.05 / $4,292.60 / $4,877.96	Professional		$1,620.05	$4,292.60	$4,877.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,051.75 / $1,577.63 / $2,460.83	Facility		$1,051.75	$1,577.63	$2,460.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,051.75 / $2,176.25 / $15,090.00	Facility		$1,051.75	$2,176.25	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,192.91 / $2,104.26 / $8,038.24	Professional		$1,192.91	$2,104.26	$8,038.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $641.93 / $2,057.86	Professional		$95.64	$641.93	$2,057.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,051.75 / $1,577.63 / $2,460.83	Facility		$1,051.75	$1,577.63	$2,460.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,158.00 / $2,629.44 / $3,925.24	Professional		$2,158.00	$2,629.44	$3,925.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,142.73 / $9,142.73 / $25,237.95	Facility		$9,142.73	$9,142.73	$25,237.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,008.33 / $5,184.50 / $8,038.24	Professional		$2,008.33	$5,184.50	$8,038.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,480.43 / $3,480.43 / $3,480.43	Professional		$3,480.43	$3,480.43	$3,480.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,870.62 / $5,347.86 / $6,831.42	Professional		$2,870.62	$5,347.86	$6,831.42
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,090.00	Facility		$8,627.00	$12,373.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,136.09 / $2,086.54 / $4,749.00	Professional		$1,136.09	$2,086.54	$4,749.00