Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,597.45 / $16,465.40 / $45,678.89	Facility		$1,597.45	$16,465.40	$45,678.89
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $5,657.94 / $5,657.94 / $6,656.40	Facility	AS	$5,657.94	$5,657.94	$6,656.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,323.92 / $2,248.76 / $14,161.34	Professional		$1,323.92	$2,248.76	$14,161.34
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $329.02 / $1,071.20 / $3,194.30	Professional	AS	$329.02	$1,071.20	$3,194.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,499.00 / $15,502.00 / $22,165.00	Facility		$11,499.00	$15,502.00	$22,165.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,387.44 / $3,205.59 / $8,558.51	Professional		$1,387.44	$3,205.59	$8,558.51
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $194.24 / $448.78 / $1,202.09	Professional	AS	$194.24	$448.78	$1,202.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,369.75 / $1,717.36 / $20,478.49	Facility		$1,369.75	$1,717.36	$20,478.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,296.90 / $1,363.92 / $1,867.47	Professional		$1,296.90	$1,363.92	$1,867.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,674.77 / $4,294.26 / $6,587.50	Facility		$3,674.77	$4,294.26	$6,587.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,152.42 / $5,659.52 / $6,431.28	Professional		$2,152.42	$5,659.52	$6,431.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,389.09 / $2,061.96 / $3,611.63	Facility		$1,389.09	$2,061.96	$3,611.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,417.94 / $3,069.89 / $21,512.00	Facility		$1,417.94	$3,069.89	$21,512.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,621.46 / $3,032.56 / $10,613.28	Professional		$1,621.46	$3,032.56	$10,613.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $848.91 / $2,689.45	Professional		$126.60	$848.91	$2,689.45
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,389.09 / $2,061.96 / $3,611.63	Facility		$1,389.09	$2,061.96	$3,611.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,843.10 / $3,464.21 / $5,171.38	Professional		$2,843.10	$3,464.21	$5,171.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $29,834.86 / $29,834.86 / $82,357.35	Facility		$29,834.86	$29,834.86	$82,357.35
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $7,806.31 / $7,806.31 / $7,806.31	Facility	AS	$7,806.31	$7,806.31	$7,806.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,647.84 / $6,913.95 / $10,613.28	Professional		$2,647.84	$6,913.95	$10,613.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,692.33 / $7,095.48 / $9,006.78	Professional		$4,692.33	$7,095.48	$9,006.78
United Facility/Professional Facility Modifier Low / Median / High Price $7,775.00 / $14,566.00 / $27,414.00	Facility		$7,775.00	$14,566.00	$27,414.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,592.74 / $2,798.66 / $6,786.39	Professional		$1,592.74	$2,798.66	$6,786.39