Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,580.55 / $5,930.43 / $28,792.70	Facility		$1,580.55	$5,930.43	$28,792.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,513.30 / $1,704.42 / $7,498.82	Professional		$1,513.30	$1,704.42	$7,498.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $14,586.00 / $21,869.00	Facility		$10,878.00	$14,586.00	$21,869.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,566.88 / $3,647.43 / $9,308.00	Professional		$1,566.88	$3,647.43	$9,308.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9,672.59 / $9,672.59 / $9,672.59	Facility		$9,672.59	$9,672.59	$9,672.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,188.41 / $4,894.47 / $7,508.26	Facility		$4,188.41	$4,894.47	$7,508.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,367.15 / $6,446.61 / $7,325.69	Professional		$2,367.15	$6,446.61	$7,325.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,580.55 / $2,193.63 / $3,493.02	Facility		$1,580.55	$2,193.63	$3,493.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,580.55 / $3,301.15 / $16,779.00	Facility		$1,580.55	$3,301.15	$16,779.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,797.95 / $3,318.41 / $12,090.08	Professional		$1,797.95	$3,318.41	$12,090.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $168.36 / $973.73 / $3,112.97	Professional		$168.36	$973.73	$3,112.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,580.55 / $2,078.84 / $3,493.02	Facility		$1,580.55	$2,078.84	$3,493.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,248.70 / $3,958.42 / $5,909.14	Professional		$3,248.70	$3,958.42	$5,909.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,213.88 / $7,213.88 / $23,559.52	Facility		$7,213.88	$7,213.88	$23,559.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,925.59 / $7,843.95 / $12,090.08	Professional		$2,925.59	$7,843.95	$12,090.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,234.45 / $5,234.45 / $5,234.45	Professional		$5,234.45	$5,234.45	$5,234.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,786.24 / $8,058.59 / $10,259.40	Professional		$4,786.24	$8,058.59	$10,259.40
United Facility/Professional Facility Modifier Low / Median / High Price $6,154.00 / $12,447.00 / $17,450.00	Facility		$6,154.00	$12,447.00	$17,450.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,764.21 / $3,443.96 / $7,004.96	Professional		$1,764.21	$3,443.96	$7,004.96