Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,182.00 / $2,490.12 / $14,482.00	Facility		$1,182.00	$2,490.12	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,136.05 / $1,231.15 / $5,479.03	Professional		$1,136.05	$1,231.15	$5,479.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,740.00 / $4,780.00 / $8,456.00	Facility		$2,740.00	$4,780.00	$8,456.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,152.53 / $2,727.69 / $6,696.30	Professional		$1,152.53	$2,727.69	$6,696.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,942.50 / $1,942.50 / $1,942.50	Facility		$1,942.50	$1,942.50	$1,942.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,139.50 / $3,668.76 / $5,627.97	Facility		$3,139.50	$3,668.76	$5,627.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,773.97 / $4,824.26 / $5,482.11	Professional		$1,773.97	$4,824.26	$5,482.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,106.72 / $1,416.60 / $2,609.77	Facility		$1,106.72	$1,416.60	$2,609.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,136.22 / $2,379.44 / $7,891.00	Facility		$1,136.22	$2,379.44	$7,891.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,260.85 / $2,360.71 / $9,036.40	Professional		$1,260.85	$2,360.71	$9,036.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $735.23 / $2,316.57	Professional		$126.60	$735.23	$2,316.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,106.72 / $1,408.39 / $2,609.77	Facility		$1,106.72	$1,408.39	$2,609.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,427.10 / $2,957.33 / $4,414.71	Professional		$2,427.10	$2,957.33	$4,414.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $5,739.80	Facility		$1,722.47	$1,722.47	$5,739.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,257.06 / $5,731.20 / $9,036.40	Professional		$2,257.06	$5,731.20	$9,036.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,765.10 / $3,765.10 / $3,765.10	Professional		$3,765.10	$3,765.10	$3,765.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,534.52 / $5,920.43 / $7,677.52	Professional		$3,534.52	$5,920.43	$7,677.52
United Facility/Professional Facility Modifier Low / Median / High Price $4,918.00 / $6,477.00 / $8,384.00	Facility		$4,918.00	$6,477.00	$8,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,240.76 / $2,342.34 / $5,215.39	Professional		$1,240.76	$2,342.34	$5,215.39