Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,479.85 / $3,113.46 / $14,482.00	Facility		$1,479.85	$3,113.46	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,423.85 / $1,535.11 / $7,037.16	Professional		$1,423.85	$1,535.11	$7,037.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,080.00 / $16,493.00 / $23,358.00	Facility		$12,080.00	$16,493.00	$23,358.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,480.15 / $3,415.03 / $9,105.91	Professional		$1,480.15	$3,415.03	$9,105.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21,184.28 / $21,184.28 / $21,184.28	Facility		$21,184.28	$21,184.28	$21,184.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,913.56 / $4,573.31 / $7,015.57	Facility		$3,913.56	$4,573.31	$7,015.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,317.92 / $6,025.36 / $6,847.00	Professional		$2,317.92	$6,025.36	$6,847.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,479.85 / $2,046.20 / $3,270.47	Facility		$1,479.85	$2,046.20	$3,270.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,479.85 / $3,113.46 / $19,562.00	Facility		$1,479.85	$3,113.46	$19,562.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,755.85 / $2,982.96 / $11,296.00	Professional		$1,755.85	$2,982.96	$11,296.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $934.77 / $2,994.31	Professional		$126.60	$934.77	$2,994.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,479.85 / $2,046.20 / $3,270.47	Facility		$1,479.85	$2,046.20	$3,270.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,029.00 / $3,690.72 / $5,509.52	Professional		$3,029.00	$3,690.72	$5,509.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $18,499.30 / $18,499.30 / $51,066.20	Facility		$18,499.30	$18,499.30	$51,066.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,734.42 / $7,361.05 / $11,296.00	Professional		$2,734.42	$7,361.05	$11,296.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,900.10 / $4,900.10 / $4,900.10	Professional		$4,900.10	$4,900.10	$4,900.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,251.12 / $9,588.95 / $9,588.95	Professional		$4,251.12	$9,588.95	$9,588.95
United Facility/Professional Facility Modifier Low / Median / High Price $8,452.00 / $17,119.00 / $22,372.00	Facility		$8,452.00	$17,119.00	$22,372.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,726.83 / $3,268.72 / $6,698.56	Professional		$1,726.83	$3,268.72	$6,698.56