Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,395.76 / $2,901.40 / $14,482.00	Facility		$1,395.76	$2,901.40	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,335.17 / $1,434.35 / $6,439.09	Professional		$1,335.17	$1,434.35	$6,439.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,326.73 / $3,220.99 / $8,663.00	Professional		$1,326.73	$3,220.99	$8,663.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,942.50 / $1,942.50 / $1,942.50	Facility		$1,942.50	$1,942.50	$1,942.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,702.70 / $4,326.89 / $6,637.58	Facility		$3,702.70	$4,326.89	$6,637.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,916.56 / $5,892.76 / $7,093.18	Professional		$1,916.56	$5,892.76	$7,093.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,289.51 / $1,650.57 / $3,084.63	Facility		$1,289.51	$1,650.57	$3,084.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,323.86 / $2,772.45 / $5,261.00	Facility		$1,323.86	$2,772.45	$5,261.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,455.16 / $2,707.65 / $10,561.36	Professional		$1,455.16	$2,707.65	$10,561.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $852.47 / $2,739.00	Professional		$126.60	$852.47	$2,739.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,289.51 / $1,650.57 / $3,084.63	Facility		$1,289.51	$1,650.57	$3,084.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,815.15 / $3,430.15 / $5,120.54	Professional		$2,815.15	$3,430.15	$5,120.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,722.47 / $1,722.47 / $6,714.32	Facility		$1,722.47	$1,722.47	$6,714.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,649.19 / $6,735.45 / $10,561.36	Professional		$2,649.19	$6,735.45	$10,561.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,646.62 / $4,646.62 / $4,646.62	Professional		$4,646.62	$4,646.62	$4,646.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,748.68 / $7,101.26 / $9,011.34	Professional		$3,748.68	$7,101.26	$9,011.34
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,400.93 / $2,683.41 / $6,169.67	Professional		$1,400.93	$2,683.41	$6,169.67