Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,320.63 / $2,784.15 / $14,482.00	Facility		$1,320.63	$2,784.15	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,261.73 / $1,407.46 / $4,594.89	Professional		$1,261.73	$1,407.46	$4,594.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,878.00 / $15,141.00 / $22,609.00	Facility		$10,878.00	$15,141.00	$22,609.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,292.17 / $3,047.60 / $8,118.76	Professional		$1,292.17	$3,047.60	$8,118.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23,627.70 / $23,627.70 / $23,627.70	Facility		$23,627.70	$23,627.70	$23,627.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,508.96 / $4,100.50 / $6,290.27	Facility		$3,508.96	$4,100.50	$6,290.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,983.81 / $5,392.30 / $6,127.61	Professional		$1,983.81	$5,392.30	$6,127.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,320.63 / $1,809.04 / $2,918.59	Facility		$1,320.63	$1,809.04	$2,918.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,320.63 / $2,735.10 / $15,090.00	Facility		$1,320.63	$2,735.10	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,496.92 / $2,731.94 / $10,099.68	Professional		$1,496.92	$2,731.94	$10,099.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $823.74 / $2,618.61	Professional		$126.60	$823.74	$2,618.61
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,320.63 / $1,730.30 / $2,918.59	Facility		$1,320.63	$1,730.30	$2,918.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,713.75 / $3,306.60 / $4,936.10	Professional		$2,713.75	$3,306.60	$4,936.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $22,605.73 / $22,605.73 / $62,401.75	Facility		$22,605.73	$22,605.73	$62,401.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,447.14 / $6,528.20 / $10,099.68	Professional		$2,447.14	$6,528.20	$10,099.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,368.91 / $4,368.91 / $4,368.91	Professional		$4,368.91	$4,368.91	$4,368.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,978.31 / $6,721.63 / $8,581.51	Professional		$3,978.31	$6,721.63	$8,581.51
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $17,327.00	Facility		$8,627.00	$12,373.00	$17,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,459.30 / $2,663.51 / $5,829.94	Professional		$1,459.30	$2,663.51	$5,829.94