Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,027.92 / $2,169.54 / $14,482.00	Facility		$1,027.92	$2,169.54	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $993.57 / $1,072.72 / $4,849.45	Professional		$993.57	$1,072.72	$4,849.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,979.00 / $6,787.00 / $10,517.23	Facility		$1,979.00	$6,787.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,018.98 / $2,372.12 / $6,332.13	Professional		$1,018.98	$2,372.12	$6,332.13
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 $2,737.60 / $3,199.11 / $4,907.51	Facility		$2,737.60	$3,199.11	$4,907.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,352.05 / $4,390.93 / $5,263.16	Professional		$1,352.05	$4,390.93	$5,263.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $869.10 / $1,202.67 / $2,179.19	Facility		$869.10	$1,202.67	$2,179.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $964.24 / $2,060.58 / $5,639.00	Facility		$964.24	$2,060.58	$5,639.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $749.31 / $2,077.00 / $7,862.72	Professional		$749.31	$2,077.00	$7,862.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $627.36 / $1,996.46	Professional		$95.64	$627.36	$1,996.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $869.10 / $1,202.67 / $2,179.19	Facility		$869.10	$1,202.67	$2,179.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,112.50 / $2,574.00 / $3,842.48	Professional		$2,112.50	$2,574.00	$3,842.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,244.77 / $3,244.77 / $8,957.00	Facility		$3,244.77	$3,244.77	$8,957.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,965.71 / $5,072.64 / $7,862.72	Professional		$1,965.71	$5,072.64	$7,862.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,396.38 / $3,396.38 / $3,396.38	Professional		$3,396.38	$3,396.38	$3,396.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,141.79 / $5,377.51 / $6,686.46	Professional		$3,141.79	$5,377.51	$6,686.46
United Facility/Professional Facility Modifier Low / Median / High Price $2,723.00 / $3,912.00 / $5,865.00	Facility		$2,723.00	$3,912.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $964.24 / $1,928.06 / $4,616.10	Professional		$964.24	$1,928.06	$4,616.10