Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,001.08 / $2,103.44 / $14,482.00	Facility		$1,001.08	$2,103.44	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $949.92 / $1,024.58 / $4,488.37	Professional		$949.92	$1,024.58	$4,488.37
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 $907.87 / $2,298.85 / $6,011.79	Professional		$907.87	$2,298.85	$6,011.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10,294.20 / $10,294.20 / $10,294.20	Facility		$10,294.20	$10,294.20	$10,294.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,712.37 / $3,169.62 / $4,862.28	Facility		$2,712.37	$3,169.62	$4,862.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,481.72 / $4,118.53 / $4,680.14	Professional		$1,481.72	$4,118.53	$4,680.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,001.08 / $1,343.92 / $2,122.29	Facility		$1,001.08	$1,343.92	$2,122.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,001.08 / $1,866.75 / $13,250.00	Facility		$1,001.08	$1,866.75	$13,250.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,054.64 / $1,887.37 / $7,630.72	Professional		$1,054.64	$1,887.37	$7,630.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $601.32 / $1,951.83	Professional		$94.25	$601.32	$1,951.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,001.08 / $1,343.92 / $2,122.29	Facility		$1,001.08	$1,343.92	$2,122.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,026.05 / $2,468.66 / $3,685.23	Professional		$2,026.05	$2,468.66	$3,685.23
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,213.88 / $7,213.88 / $19,913.50	Facility		$7,213.88	$7,213.88	$19,913.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,926.89 / $4,694.95 / $7,630.72	Professional		$1,926.89	$4,694.95	$7,630.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,380.80 / $3,380.80 / $3,380.80	Professional		$3,380.80	$3,380.80	$3,380.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,742.11 / $5,061.63 / $6,554.43	Professional		$2,742.11	$5,061.63	$6,554.43
United Facility/Professional Facility Modifier Low / Median / High Price $5,266.00 / $11,608.00 / $13,980.00	Facility		$5,266.00	$11,608.00	$13,980.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,025.00 / $1,821.64 / $4,272.39	Professional		$1,025.00	$1,821.64	$4,272.39