Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,179.92 / $2,487.06 / $14,482.00	Facility		$1,179.92	$2,487.06	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,042.75 / $1,229.72 / $5,471.00	Professional		$1,042.75	$1,229.72	$5,471.00
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 $1,165.50 / $2,722.90 / $7,253.07	Professional		$1,165.50	$2,722.90	$7,253.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,560.77 / $7,560.77 / $7,560.77	Facility		$7,560.77	$7,560.77	$7,560.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,136.80 / $3,665.60 / $5,623.12	Facility		$3,136.80	$3,665.60	$5,623.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,758.83 / $4,818.22 / $5,475.26	Professional		$1,758.83	$4,818.22	$5,475.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,179.92 / $1,545.72 / $2,607.62	Facility		$1,179.92	$1,545.72	$2,607.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,179.92 / $2,463.48 / $15,090.00	Facility		$1,179.92	$2,463.48	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,275.41 / $2,327.96 / $9,021.60	Professional		$1,275.41	$2,327.96	$9,021.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $734.76 / $2,362.76	Professional		$126.60	$734.76	$2,362.76
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,179.92 / $1,545.72 / $2,607.62	Facility		$1,179.92	$1,545.72	$2,607.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,423.19 / $2,952.58 / $4,407.60	Professional		$2,423.19	$2,952.58	$4,407.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,143.35 / $9,143.35 / $25,239.65	Facility		$9,143.35	$9,143.35	$25,239.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,186.62 / $5,819.90 / $9,021.60	Professional		$2,186.62	$5,819.90	$9,021.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,903.04 / $3,903.04 / $3,903.04	Professional		$3,903.04	$3,903.04	$3,903.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,493.49 / $6,002.27 / $7,667.98	Professional		$3,493.49	$6,002.27	$7,667.98
United Facility/Professional Facility Modifier Low / Median / High Price $8,627.00 / $12,373.00 / $15,090.00	Facility		$8,627.00	$12,373.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,280.38 / $2,359.33 / $5,541.69	Professional		$1,280.38	$2,359.33	$5,541.69