Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,236.40 / $2,607.57 / $14,482.00	Facility		$1,236.40	$2,607.57	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,187.58 / $1,289.22 / $5,829.45	Professional		$1,187.58	$1,289.22	$5,829.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,287.00 / $15,141.00 / $22,609.00	Facility		$9,287.00	$15,141.00	$22,609.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,220.36 / $2,853.24 / $7,595.50	Professional		$1,220.36	$2,853.24	$7,595.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14,551.22 / $14,551.22 / $14,551.22	Facility		$14,551.22	$14,551.22	$14,551.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,289.09 / $3,843.56 / $5,896.12	Facility		$3,289.09	$3,843.56	$5,896.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,859.22 / $5,051.17 / $5,739.96	Professional		$1,859.22	$5,051.17	$5,739.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,236.40 / $1,730.52 / $2,727.80	Facility		$1,236.40	$1,730.52	$2,727.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,236.40 / $2,491.67 / $15,090.00	Facility		$1,236.40	$2,491.67	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,341.51 / $2,473.36 / $9,454.64	Professional		$1,341.51	$2,473.36	$9,454.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $771.84 / $2,434.60	Professional		$126.60	$771.84	$2,434.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,236.40 / $1,730.52 / $2,727.80	Facility		$1,236.40	$1,730.52	$2,727.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,539.55 / $3,094.34 / $4,619.25	Professional		$2,539.55	$3,094.34	$4,619.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13,629.66 / $13,629.66 / $37,623.85	Facility		$13,629.66	$13,629.66	$37,623.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,363.21 / $6,097.75 / $9,454.64	Professional		$2,363.21	$6,097.75	$9,454.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,087.33 / $4,087.33 / $4,087.33	Professional		$4,087.33	$4,087.33	$4,087.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,984.31 / $6,284.88 / $8,038.61	Professional		$2,984.31	$6,284.88	$8,038.61
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 $1,337.57 / $2,439.10 / $5,585.54	Professional		$1,337.57	$2,439.10	$5,585.54