Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,088.19 / $2,290.54 / $14,482.00	Facility		$1,088.19	$2,290.54	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,046.04 / $1,132.66 / $5,136.06	Professional		$1,046.04	$1,132.66	$5,136.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $12,444.00	Facility		$5,169.00	$8,408.00	$12,444.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,072.36 / $2,511.21 / $6,694.82	Professional		$1,072.36	$2,511.21	$6,694.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,462.54 / $3,462.54 / $3,462.54	Facility		$3,462.54	$3,462.54	$3,462.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,888.09 / $3,374.96 / $5,177.28	Facility		$2,888.09	$3,374.96	$5,177.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,708.08 / $4,439.49 / $5,044.88	Professional		$1,708.08	$4,439.49	$5,044.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,088.19 / $1,511.91 / $2,404.90	Facility		$1,088.19	$1,511.91	$2,404.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,088.19 / $2,188.73 / $13,250.00	Facility		$1,088.19	$2,188.73	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,280.58 / $2,353.13 / $8,633.91	Professional		$1,280.58	$2,353.13	$8,633.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $662.15 / $2,132.31	Professional		$95.64	$662.15	$2,132.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,088.19 / $1,511.91 / $2,404.90	Facility		$1,088.19	$1,511.91	$2,404.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,233.40 / $2,721.31 / $4,062.38	Professional		$2,233.40	$2,721.31	$4,062.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,231.11 / $9,231.11 / $25,481.90	Facility		$9,231.11	$9,231.11	$25,481.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,077.05 / $5,372.45 / $8,633.91	Professional		$2,077.05	$5,372.45	$8,633.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,602.63 / $3,602.63 / $3,602.63	Professional		$3,602.63	$3,602.63	$3,602.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,557.98 / $5,539.22 / $7,065.18	Professional		$2,557.98	$5,539.22	$7,065.18
United Facility/Professional Facility Modifier Low / Median / High Price $7,301.00 / $11,608.00 / $13,980.00	Facility		$7,301.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,237.25 / $2,182.17 / $4,888.93	Professional		$1,237.25	$2,182.17	$4,888.93