Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,289.70 / $2,717.24 / $14,482.00	Facility		$1,289.70	$2,717.24	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,240.68 / $1,343.65 / $6,119.17	Professional		$1,240.68	$1,343.65	$6,119.17
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 $1,277.80 / $2,976.23 / $7,933.67	Professional		$1,277.80	$2,976.23	$7,933.67
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 $3,422.45 / $3,999.41 / $6,135.19	Facility		$3,422.45	$3,999.41	$6,135.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,677.34 / $5,264.23 / $5,982.08	Professional		$1,677.34	$5,264.23	$5,982.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,207.66 / $1,673.25 / $2,734.16	Facility		$1,207.66	$1,673.25	$2,734.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,243.07 / $2,596.46 / $13,250.00	Facility		$1,243.07	$2,596.46	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,064.76 / $2,584.90 / $9,868.71	Professional		$1,064.76	$2,584.90	$9,868.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $808.48 / $2,553.60	Professional		$126.60	$808.48	$2,553.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,207.66 / $1,575.00 / $2,734.16	Facility		$1,207.66	$1,575.00	$2,734.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,651.35 / $3,230.57 / $4,822.60	Professional		$2,651.35	$3,230.57	$4,822.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,663.04 / $9,663.04 / $26,674.30	Facility		$9,663.04	$9,663.04	$26,674.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,462.90 / $6,400.80 / $9,868.71	Professional		$2,462.90	$6,400.80	$9,868.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,269.29 / $4,269.29 / $4,269.29	Professional		$4,269.29	$4,269.29	$4,269.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,131.65 / $6,578.30 / $8,377.70	Professional		$2,131.65	$6,578.30	$8,377.70
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 $1,207.66 / $2,584.90 / $5,705.13	Professional		$1,207.66	$2,584.90	$5,705.13