Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,232.10 / $2,599.11 / $14,482.00	Facility		$1,232.10	$2,599.11	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,183.47 / $1,310.81 / $5,812.29	Professional		$1,183.47	$1,310.81	$5,812.29
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 $1,217.38 / $2,843.34 / $7,571.61	Professional		$1,217.38	$2,843.34	$7,571.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27,585.84 / $27,585.84 / $27,585.84	Facility		$27,585.84	$27,585.84	$27,585.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,278.27 / $3,830.92 / $5,876.73	Facility		$3,278.27	$3,830.92	$5,876.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,853.17 / $5,034.16 / $5,720.64	Professional		$1,853.17	$5,034.16	$5,720.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,232.10 / $1,704.33 / $2,722.96	Facility		$1,232.10	$1,704.33	$2,722.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,232.10 / $2,570.78 / $15,090.00	Facility		$1,232.10	$2,570.78	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,376.34 / $2,455.46 / $9,423.28	Professional		$1,376.34	$2,455.46	$9,423.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $771.84 / $2,434.60	Professional		$126.60	$771.84	$2,434.60
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,232.10 / $1,612.80 / $2,722.96	Facility		$1,232.10	$1,612.80	$2,722.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,531.75 / $3,084.84 / $4,605.06	Professional		$2,531.75	$3,084.84	$4,605.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $20,573.68 / $20,573.68 / $56,792.45	Facility		$20,573.68	$20,573.68	$56,792.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,284.60 / $6,079.80 / $9,423.28	Professional		$2,284.60	$6,079.80	$9,423.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,074.47 / $4,074.47 / $4,074.47	Professional		$4,074.47	$4,074.47	$4,074.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,813.78 / $6,267.29 / $8,011.56	Professional		$2,813.78	$6,267.29	$8,011.56
United Facility/Professional Facility Modifier Low / Median / High Price $6,154.00 / $11,891.00 / $15,090.00	Facility		$6,154.00	$11,891.00	$15,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,368.22 / $2,569.48 / $5,834.54	Professional		$1,368.22	$2,569.48	$5,834.54