Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,050.02 / $2,210.67 / $14,482.00	Facility		$1,050.02	$2,210.67	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,008.89 / $1,092.81 / $4,947.97	Professional		$1,008.89	$1,092.81	$4,947.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $15,141.00 / $22,609.00	Facility		$10,878.00	$15,141.00	$22,609.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,036.24 / $2,423.13 / $6,456.31	Professional		$1,036.24	$2,423.13	$6,456.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22,125.22 / $22,125.22 / $22,125.22	Facility		$22,125.22	$22,125.22	$22,125.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,789.87 / $3,260.18 / $5,001.20	Facility		$2,789.87	$3,260.18	$5,001.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,581.50 / $4,285.63 / $4,870.04	Professional		$1,581.50	$4,285.63	$4,870.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,050.02 / $1,561.08 / $2,456.30	Facility		$1,050.02	$1,561.08	$2,456.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,050.02 / $2,196.69 / $15,090.00	Facility		$1,050.02	$2,196.69	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,188.69 / $2,093.16 / $8,025.36	Professional		$1,188.69	$2,093.16	$8,025.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $641.93 / $2,057.86	Professional		$95.64	$641.93	$2,057.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,050.02 / $1,561.08 / $2,456.30	Facility		$1,050.02	$1,561.08	$2,456.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,153.44 / $2,623.90 / $3,916.96	Professional		$2,153.44	$2,623.90	$3,916.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $18,448.73 / $18,448.73 / $50,926.60	Facility		$18,448.73	$18,448.73	$50,926.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,005.06 / $5,175.70 / $8,025.36	Professional		$2,005.06	$5,175.70	$8,025.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,474.29 / $3,474.29 / $3,474.29	Professional		$3,474.29	$3,474.29	$3,474.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,126.42 / $5,337.83 / $6,820.35	Professional		$3,126.42	$5,337.83	$6,820.35
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 $1,141.33 / $2,075.16 / $4,966.91	Professional		$1,141.33	$2,075.16	$4,966.91