Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,036.39 / $2,168.57 / $14,482.00	Facility		$1,036.39	$2,168.57	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $990.98 / $1,072.03 / $4,682.68	Professional		$990.98	$1,072.03	$4,682.68
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 $951.27 / $2,390.07 / $6,112.64	Professional		$951.27	$2,390.07	$6,112.64
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 $2,760.13 / $3,225.43 / $4,947.89	Facility		$2,760.13	$3,225.43	$4,947.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,553.05 / $4,219.16 / $4,794.50	Professional		$1,553.05	$4,219.16	$4,794.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,036.39 / $1,450.95 / $2,197.15	Facility		$1,036.39	$1,450.95	$2,197.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,036.39 / $1,992.65 / $13,250.00	Facility		$1,036.39	$1,992.65	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,077.59 / $2,037.00 / $7,865.52	Professional		$1,077.59	$2,037.00	$7,865.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $636.38 / $2,032.92	Professional		$94.25	$636.38	$2,032.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,036.39 / $1,445.72 / $2,197.15	Facility		$1,036.39	$1,445.72	$2,197.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,102.75 / $2,562.12 / $3,824.74	Professional		$2,102.75	$2,562.12	$3,824.74
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 $1,973.95 / $4,898.20 / $7,865.52	Professional		$1,973.95	$4,898.20	$7,865.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,437.51 / $3,437.51 / $3,437.51	Professional		$3,437.51	$3,437.51	$3,437.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,202.71 / $5,198.71 / $6,714.54	Professional		$2,202.71	$5,198.71	$6,714.54
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,067.89 / $1,959.28 / $4,457.35	Professional		$1,067.89	$1,959.28	$4,457.35