Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,046.00 / $3,366.88 / $10,659.40	Facility		$2,046.00	$3,366.88	$10,659.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,000.00 / $3,919.60 / $5,736.00	Professional		$3,000.00	$3,919.60	$5,736.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,277.00 / $12,428.00 / $13,145.00	Facility		$10,277.00	$12,428.00	$13,145.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,912.00 / $3,298.20 / $20,473.75	Professional		$1,912.00	$3,298.20	$20,473.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,596.95 / $11,681.87 / $12,141.20	Facility		$3,596.95	$11,681.87	$12,141.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13,154.55 / $15,372.13 / $23,581.24	Facility		$13,154.55	$15,372.13	$23,581.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,112.50 / $6,975.46 / $14,626.80	Professional		$3,112.50	$6,975.46	$14,626.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,490.00 / $4,302.00 / $9,397.68	Facility		$2,490.00	$4,302.00	$9,397.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,490.00 / $4,493.20 / $22,705.00	Facility		$2,490.00	$4,493.20	$22,705.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,151.00 / $3,824.00 / $13,240.60	Professional		$2,151.00	$3,824.00	$13,240.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $4,780.00	Professional		$55.00	$85.00	$4,780.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,490.00 / $4,302.00 / $9,397.68	Facility		$2,490.00	$4,302.00	$9,397.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7,979.58 / $11,397.50 / $15,985.76	Professional		$7,979.58	$11,397.50	$15,985.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,533.40 / $9,560.00 / $22,705.00	Facility		$2,533.40	$9,560.00	$22,705.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,533.40 / $23,900.00 / $23,900.00	Professional		$2,533.40	$23,900.00	$23,900.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,780.00 / $4,780.00 / $10,179.21	Professional		$4,780.00	$4,780.00	$10,179.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,780.00 / $4,780.00 / $26,098.80	Professional		$4,780.00	$4,780.00	$26,098.80
United Facility/Professional Professional Modifier Low / Median / High Price $2,390.00 / $2,868.00 / $10,038.00	Professional		$2,390.00	$2,868.00	$10,038.00