Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,181.52 / $2,493.94 / $14,482.00	Facility		$1,181.52	$2,493.94	$14,482.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,051.57 / $1,254.66 / $4,710.79	Professional		$1,051.57	$1,254.66	$4,710.79
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 $1,166.79 / $2,726.59 / $7,255.71	Professional		$1,166.79	$2,726.59	$7,255.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14,551.22 / $14,551.22 / $14,551.22	Facility		$14,551.22	$14,551.22	$14,551.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,146.71 / $3,677.18 / $5,640.89	Facility		$3,146.71	$3,677.18	$5,640.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,779.02 / $4,829.89 / $5,488.53	Professional		$1,779.02	$4,829.89	$5,488.53
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,181.52 / $1,665.87 / $2,771.05	Facility		$1,181.52	$1,665.87	$2,771.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,181.52 / $2,466.92 / $15,090.00	Facility		$1,181.52	$2,466.92	$15,090.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,334.71 / $2,548.39 / $9,345.25	Professional		$1,334.71	$2,548.39	$9,345.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $724.88 / $2,323.66	Professional		$126.60	$724.88	$2,323.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,181.52 / $1,665.87 / $2,771.05	Facility		$1,181.52	$1,665.87	$2,771.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,427.10 / $2,957.33 / $4,414.71	Professional		$2,427.10	$2,957.33	$4,414.71
Quartz Facility/Professional Facility Modifier Low / Median / High Price $17,420.95 / $17,420.95 / $48,089.50	Facility		$17,420.95	$17,420.95	$48,089.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,259.71 / $5,818.25 / $9,345.25	Professional		$2,259.71	$5,818.25	$9,345.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,904.48 / $3,904.48 / $3,904.48	Professional		$3,904.48	$3,904.48	$3,904.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,934.09 / $6,002.17 / $7,686.51	Professional		$3,934.09	$6,002.17	$7,686.51
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 $1,291.06 / $2,346.42 / $5,294.61	Professional		$1,291.06	$2,346.42	$5,294.61