Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,123.40 / $2,366.66 / $14,482.00	Facility		$1,123.40	$2,366.66	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,079.65 / $1,170.16 / $5,304.08	Professional		$1,079.65	$1,170.16	$5,304.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,110.92 / $2,592.46 / $6,913.23	Professional		$1,110.92	$2,592.46	$6,913.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10,519.08 / $10,519.08 / $10,519.08	Facility		$10,519.08	$10,519.08	$10,519.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,985.41 / $3,488.69 / $5,351.74	Facility		$2,985.41	$3,488.69	$5,351.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,764.58 / $4,586.92 / $5,212.41	Professional		$1,764.58	$4,586.92	$5,212.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,123.40 / $1,630.86 / $2,629.63	Facility		$1,123.40	$1,630.86	$2,629.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,123.40 / $2,324.77 / $15,090.00	Facility		$1,123.40	$2,324.77	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,322.27 / $2,430.11 / $8,810.18	Professional		$1,322.27	$2,430.11	$8,810.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $691.08 / $2,197.32	Professional		$95.64	$691.08	$2,197.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,123.40 / $1,630.86 / $2,629.63	Facility		$1,123.40	$1,630.86	$2,629.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,306.85 / $2,810.81 / $4,195.97	Professional		$2,306.85	$2,810.81	$4,195.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,143.35 / $9,143.35 / $25,239.65	Facility		$9,143.35	$9,143.35	$25,239.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,146.03 / $5,548.20 / $8,810.18	Professional		$2,146.03	$5,548.20	$8,810.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,720.19 / $3,720.19 / $3,720.19	Professional		$3,720.19	$3,720.19	$3,720.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,813.78 / $5,721.14 / $7,299.84	Professional		$2,813.78	$5,721.14	$7,299.84
United Facility/Professional Facility Modifier Low / Median / High Price $6,154.00 / $12,373.00 / $17,327.00	Facility		$6,154.00	$12,373.00	$17,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,277.41 / $2,400.48 / $5,065.51	Professional		$1,277.41	$2,400.48	$5,065.51