Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,345.87 / $2,804.96 / $14,482.00	Facility		$1,345.87	$2,804.96	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,283.98 / $1,386.83 / $6,154.30	Professional		$1,283.98	$1,386.83	$6,154.30
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 $1,267.25 / $3,105.85 / $8,338.77	Professional		$1,267.25	$3,105.85	$8,338.77
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 $3,588.26 / $4,193.17 / $6,432.42	Facility		$3,588.26	$4,193.17	$6,432.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,002.45 / $5,713.80 / $6,854.78	Professional		$2,002.45	$5,713.80	$6,854.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,345.87 / $1,852.59 / $2,974.37	Facility		$1,345.87	$1,852.59	$2,974.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,345.87 / $2,652.07 / $11,100.00	Facility		$1,345.87	$2,652.07	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,416.34 / $2,587.90 / $10,203.00	Professional		$1,416.34	$2,587.90	$10,203.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $822.77 / $2,637.43	Professional		$126.60	$822.77	$2,637.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,345.87 / $1,774.15 / $2,974.37	Facility		$1,345.87	$1,774.15	$2,974.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,714.40 / $3,307.39 / $4,937.28	Professional		$2,714.40	$3,307.39	$4,937.28
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 $2,560.13 / $6,437.55 / $10,203.00	Professional		$2,560.13	$6,437.55	$10,203.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,472.68 / $4,472.68 / $4,472.68	Professional		$4,472.68	$4,472.68	$4,472.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,854.93 / $6,819.12 / $8,708.42	Professional		$3,854.93	$6,819.12	$8,708.42
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 $1,405.07 / $2,575.02 / $5,877.48	Professional		$1,405.07	$2,575.02	$5,877.48