Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,082.08 / $2,277.65 / $14,482.00	Facility		$1,082.08	$2,277.65	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,040.14 / $1,126.16 / $5,107.81	Professional		$1,040.14	$1,126.16	$5,107.81
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 $1,070.71 / $2,497.12 / $6,371.22	Professional		$1,070.71	$2,497.12	$6,371.22
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 $2,872.77 / $3,357.06 / $5,149.82	Facility		$2,872.77	$3,357.06	$5,149.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,698.58 / $4,415.63 / $5,017.76	Professional		$1,698.58	$4,415.63	$5,017.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,082.08 / $1,518.44 / $2,391.42	Facility		$1,082.08	$1,518.44	$2,391.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,082.08 / $2,176.42 / $13,120.00	Facility		$1,082.08	$2,176.42	$13,120.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,273.48 / $2,340.19 / $8,271.92	Professional		$1,273.48	$2,340.19	$8,271.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $641.93 / $2,088.96	Professional		$95.64	$641.93	$2,088.96
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,082.08 / $1,514.93 / $2,391.42	Facility		$1,082.08	$1,514.93	$2,391.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,220.40 / $2,705.47 / $4,038.74	Professional		$2,220.40	$2,705.47	$4,038.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,280.92 / $4,280.92 / $11,817.20	Facility		$4,280.92	$4,280.92	$11,817.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,065.88 / $5,342.90 / $8,271.92	Professional		$2,065.88	$5,342.90	$8,271.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,582.93 / $3,582.93 / $3,582.93	Professional		$3,582.93	$3,582.93	$3,582.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,700.09 / $5,507.67 / $7,027.21	Professional		$2,700.09	$5,507.67	$7,027.21
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 $1,175.44 / $2,254.21 / $5,127.37	Professional		$1,175.44	$2,254.21	$5,127.37