Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,084.75 / $2,282.15 / $14,482.00	Facility		$1,084.75	$2,282.15	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,040.52 / $1,147.69 / $5,059.82	Professional		$1,040.52	$1,147.69	$5,059.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,287.00 / $13,743.77 / $21,606.00	Facility		$9,287.00	$13,743.77	$21,606.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,065.10 / $2,503.28 / $6,653.33	Professional		$1,065.10	$2,503.28	$6,653.33
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 $2,891.69 / $3,379.17 / $5,183.74	Facility		$2,891.69	$3,379.17	$5,183.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,628.71 / $4,436.75 / $5,041.76	Professional		$1,628.71	$4,436.75	$5,041.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,084.75 / $1,565.91 / $2,535.73	Facility		$1,084.75	$1,565.91	$2,535.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,084.75 / $2,243.78 / $13,250.00	Facility		$1,084.75	$2,243.78	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,210.08 / $2,159.48 / $8,747.54	Professional		$1,210.08	$2,159.48	$8,747.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $125.82 / $660.67 / $2,107.45	Professional		$125.82	$660.67	$2,107.45
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,084.75 / $1,565.91 / $2,535.73	Facility		$1,084.75	$1,565.91	$2,535.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,217.15 / $2,701.51 / $4,032.83	Professional		$2,217.15	$2,701.51	$4,032.83
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 $2,075.76 / $5,292.70 / $8,747.54	Professional		$2,075.76	$5,292.70	$8,747.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,580.33 / $3,580.33 / $3,580.33	Professional		$3,580.33	$3,580.33	$3,580.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,842.20 / $5,490.56 / $7,060.82	Professional		$2,842.20	$5,490.56	$7,060.82
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 $1,209.93 / $2,117.08 / $5,079.18	Professional		$1,209.93	$2,117.08	$5,079.18