Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,217.02 / $2,572.16 / $14,482.00	Facility		$1,217.02	$2,572.16	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,167.36 / $1,290.09 / $5,014.97	Professional		$1,167.36	$1,290.09	$5,014.97
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 $1,195.15 / $2,465.65 / $7,467.93	Professional		$1,195.15	$2,465.65	$7,467.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19,405.16 / $19,405.16 / $19,405.16	Facility		$19,405.16	$19,405.16	$19,405.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,246.74 / $3,794.07 / $5,820.20	Facility		$3,246.74	$3,794.07	$5,820.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,836.52 / $4,978.75 / $5,657.68	Professional		$1,836.52	$4,978.75	$5,657.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,217.02 / $1,714.77 / $2,689.61	Facility		$1,217.02	$1,714.77	$2,689.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,217.02 / $2,532.21 / $15,090.00	Facility		$1,217.02	$2,532.21	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,342.32 / $2,614.94 / $9,307.52	Professional		$1,342.32	$2,614.94	$9,307.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $763.57 / $2,434.60	Professional		$126.60	$763.57	$2,434.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,217.02 / $1,703.83 / $2,689.61	Facility		$1,217.02	$1,703.83	$2,689.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,501.85 / $3,048.41 / $4,550.67	Professional		$2,501.85	$3,048.41	$4,550.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $19,338.93 / $19,338.93 / $53,383.95	Facility		$19,338.93	$19,338.93	$53,383.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,329.33 / $5,970.20 / $9,307.52	Professional		$2,329.33	$5,970.20	$9,307.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,018.65 / $4,018.65 / $4,018.65	Professional		$4,018.65	$4,018.65	$4,018.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,603.29 / $6,167.91 / $7,923.38	Professional		$3,603.29	$6,167.91	$7,923.38
United Facility/Professional Facility Modifier Low / Median / High Price $7,984.00 / $13,721.00 / $17,450.00	Facility		$7,984.00	$13,721.00	$17,450.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,313.36 / $2,505.44 / $5,432.88	Professional		$1,313.36	$2,505.44	$5,432.88