Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,608.37 / $3,119.00 / $14,482.00	Facility		$1,608.37	$3,119.00	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,538.81 / $1,651.99 / $7,491.50	Professional		$1,538.81	$1,651.99	$7,491.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,060.00 / $7,344.00 / $10,517.23	Facility		$5,060.00	$7,344.00	$10,517.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,550.00 / $3,711.62 / $9,537.42	Professional		$1,550.00	$3,711.62	$9,537.42
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 $4,259.59 / $4,977.67 / $7,635.88	Facility		$4,259.59	$4,977.67	$7,635.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,385.81 / $6,771.80 / $8,164.45	Professional		$2,385.81	$6,771.80	$8,164.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,608.37 / $2,251.71 / $3,409.74	Facility		$1,608.37	$2,251.71	$3,409.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,608.37 / $3,187.27 / $11,100.00	Facility		$1,608.37	$3,187.27	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,712.57 / $3,276.87 / $12,159.92	Professional		$1,712.57	$3,276.87	$12,159.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $978.80 / $3,144.50	Professional		$126.60	$978.80	$3,144.50
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,608.37 / $2,223.67 / $3,409.74	Facility		$1,608.37	$2,223.67	$3,409.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,237.00 / $3,944.16 / $5,887.85	Professional		$3,237.00	$3,944.16	$5,887.85
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 $3,049.28 / $7,836.30 / $12,159.92	Professional		$3,049.28	$7,836.30	$12,159.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,363.47 / $5,363.47 / $5,363.47	Professional		$5,363.47	$5,363.47	$5,363.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,743.10 / $8,276.96 / $10,372.34	Professional		$4,743.10	$8,276.96	$10,372.34
United Facility/Professional Facility Modifier Low / Median / High Price $4,240.00 / $9,158.00 / $12,062.00	Facility		$4,240.00	$9,158.00	$12,062.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,711.73 / $3,143.28 / $7,131.03	Professional		$1,711.73	$3,143.28	$7,131.03