Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,189.86 / $2,737.32 / $4,069.48	Facility		$2,189.86	$2,737.32	$4,069.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,075.00 / $1,733.64 / $2,189.86	Professional		$1,075.00	$1,733.64	$2,189.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,923.49 / $4,744.68 / $5,018.42	Facility		$3,923.49	$4,744.68	$5,018.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $901.17 / $1,824.88 / $7,846.98	Professional		$901.17	$1,824.88	$7,846.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,824.88 / $2,710.41 / $5,368.32	Facility		$1,824.88	$2,710.41	$5,368.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,824.88 / $1,916.12 / $2,359.71	Professional		$1,824.88	$1,916.12	$2,359.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,021.93 / $5,868.54 / $9,002.48	Facility		$5,021.93	$5,868.54	$9,002.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,097.21 / $4,914.04 / $5,584.14	Professional		$2,097.21	$4,914.04	$5,584.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,405.16 / $2,189.86 / $6,387.08	Facility		$1,405.16	$2,189.86	$6,387.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,642.39 / $2,189.86 / $6,387.08	Facility		$1,642.39	$2,189.86	$6,387.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,058.43 / $1,491.52 / $6,569.57	Professional		$1,058.43	$1,491.52	$6,569.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,471.63	Professional		$50.00	$70.00	$1,471.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,405.16 / $2,189.86 / $6,387.08	Facility		$1,405.16	$2,189.86	$6,387.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,667.30 / $4,752.47 / $6,206.20	Professional		$3,667.30	$4,752.47	$6,206.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,649.76 / $8,668.18 / $8,668.18	Facility		$3,649.76	$8,668.18	$8,668.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,306.28 / $9,124.40 / $9,124.40	Professional		$2,306.28	$9,124.40	$9,124.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,877.45 / $1,877.45 / $3,886.16	Professional		$1,877.45	$1,877.45	$3,886.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,877.45 / $6,183.76 / $9,963.84	Professional		$1,877.45	$6,183.76	$9,963.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,824.88 / $1,824.88 / $1,824.88	Facility		$1,824.88	$1,824.88	$1,824.88
United Facility/Professional Professional Modifier Low / Median / High Price $1,044.06 / $1,459.90 / $5,001.08	Professional		$1,044.06	$1,459.90	$5,001.08