Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,132.14 / $2,389.36 / $14,482.00	Facility		$1,132.14	$2,389.36	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,073.44 / $1,132.14 / $5,466.60	Professional		$1,073.44	$1,132.14	$5,466.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,169.00 / $8,408.00 / $12,444.00	Facility		$5,169.00	$8,408.00	$12,444.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,140.17 / $2,612.64 / $6,832.80	Professional		$1,140.17	$2,612.64	$6,832.80
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 $3,030.47 / $3,541.34 / $5,432.51	Facility		$3,030.47	$3,541.34	$5,432.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,657.75 / $4,638.57 / $5,271.10	Professional		$1,657.75	$4,638.57	$5,271.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,080.20 / $1,610.00 / $2,450.23	Facility		$1,080.20	$1,610.00	$2,450.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,132.14 / $2,254.17 / $11,100.00	Facility		$1,132.14	$2,254.17	$11,100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,200.72 / $2,405.69 / $8,573.52	Professional		$1,200.72	$2,405.69	$8,573.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $666.60 / $2,191.21	Professional		$126.60	$666.60	$2,191.21
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,080.20 / $1,610.00 / $2,450.23	Facility		$1,080.20	$1,610.00	$2,450.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,217.80 / $2,702.30 / $4,034.01	Professional		$2,217.80	$2,702.30	$4,034.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,244.77 / $3,244.77 / $9,352.42	Facility		$3,244.77	$3,244.77	$9,352.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,170.17 / $5,718.20 / $8,573.52	Professional		$2,170.17	$5,718.20	$8,573.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,842.53 / $3,842.53 / $3,842.53	Professional		$3,842.53	$3,842.53	$3,842.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,158.54 / $5,897.64 / $7,382.00	Professional		$3,158.54	$5,897.64	$7,382.00
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 $1,151.25 / $2,256.21 / $5,203.56	Professional		$1,151.25	$2,256.21	$5,203.56