Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,269.49 / $2,877.26 / $14,482.00	Facility		$1,269.49	$2,877.26	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,229.10 / $1,395.61 / $6,017.88	Professional		$1,229.10	$1,395.61	$6,017.88
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 $1,267.77 / $2,929.59 / $7,529.11	Professional		$1,267.77	$2,929.59	$7,529.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,971.90 / $2,971.90 / $2,971.90	Facility		$2,971.90	$2,971.90	$2,971.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,621.60 / $4,232.13 / $6,492.19	Facility		$3,621.60	$4,232.13	$6,492.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,773.46 / $5,575.74 / $6,336.06	Professional		$1,773.46	$5,575.74	$6,336.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,269.49 / $1,674.79 / $2,877.26	Facility		$1,269.49	$1,674.79	$2,877.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,278.78 / $2,691.32 / $5,639.00	Facility		$1,278.78	$2,691.32	$5,639.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,278.78 / $2,544.42 / $11,054.14	Professional		$1,278.78	$2,544.42	$11,054.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $848.91 / $2,689.45	Professional		$126.60	$848.91	$2,689.45
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,269.49 / $1,636.84 / $2,877.26	Facility		$1,269.49	$1,636.84	$2,877.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,809.30 / $3,423.02 / $5,109.89	Professional		$2,809.30	$3,423.02	$5,109.89
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,469.60 / $2,469.60 / $18,263.52	Facility		$2,469.60	$2,469.60	$18,263.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,608.63 / $6,294.85 / $11,054.14	Professional		$2,608.63	$6,294.85	$11,054.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,234.09 / $4,234.09 / $4,234.09	Professional		$4,234.09	$4,234.09	$4,234.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,839.46 / $6,529.17 / $8,873.44	Professional		$3,839.46	$6,529.17	$8,873.44
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 $1,278.78 / $2,544.42 / $5,728.31	Professional		$1,278.78	$2,544.42	$5,728.31