Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,696.60 / $2,958.16 / $4,780.22	Facility		$1,696.60	$2,958.16	$4,780.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,286.16 / $2,014.98 / $2,572.32	Professional		$1,286.16	$2,014.98	$2,572.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,608.74 / $5,573.36 / $5,894.90	Facility		$4,608.74	$5,573.36	$5,894.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $857.44 / $1,307.58 / $8,574.40	Professional		$857.44	$1,307.58	$8,574.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,628.42 / $5,238.76 / $5,444.74	Facility		$1,628.42	$5,238.76	$5,444.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,899.63 / $6,894.19 / $10,575.86	Facility		$5,899.63	$6,894.19	$10,575.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,136.10 / $3,128.18 / $6,559.41	Professional		$1,136.10	$3,128.18	$6,559.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,286.16 / $1,929.24 / $4,214.41	Facility		$1,286.16	$1,929.24	$4,214.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,286.16 / $2,014.98 / $10,182.10	Facility		$1,286.16	$2,014.98	$10,182.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $361.26 / $1,286.16 / $5,937.77	Professional		$361.26	$1,286.16	$5,937.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $3,215.40	Professional		$55.00	$85.00	$3,215.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,286.16 / $1,929.24 / $4,214.41	Facility		$1,286.16	$1,929.24	$4,214.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,148.58 / $5,111.41 / $7,169.09	Professional		$1,148.58	$5,111.41	$7,169.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,136.10 / $4,287.20 / $10,182.10	Facility		$1,136.10	$4,287.20	$10,182.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,136.10 / $10,718.00 / $10,718.00	Professional		$1,136.10	$10,718.00	$10,718.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $451.58 / $451.58 / $4,564.89	Professional		$451.58	$451.58	$4,564.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $451.58 / $6,229.76 / $11,704.06	Professional		$451.58	$6,229.76	$11,704.06
United Facility/Professional Facility Modifier Low / Median / High Price $2,143.60 / $2,143.60 / $2,143.60	Facility		$2,143.60	$2,143.60	$2,143.60
United Facility/Professional Professional Modifier Low / Median / High Price $361.26 / $1,286.16 / $3,322.58	Professional		$361.26	$1,286.16	$3,322.58