Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,358.08 / $3,503.52 / $6,510.71	Facility		$3,358.08	$3,503.52	$6,510.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,335.67 / $2,919.60 / $3,503.52	Professional		$2,335.67	$2,919.60	$3,503.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,277.14 / $7,590.96 / $8,028.90	Facility		$6,277.14	$7,590.96	$8,028.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,167.83 / $2,014.52 / $12,505.26	Professional		$1,167.83	$2,014.52	$12,505.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,919.60 / $3,503.52 / $7,415.78	Facility		$2,919.60	$3,503.52	$7,415.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,919.60 / $2,919.60 / $3,775.04	Professional		$2,919.60	$2,919.60	$3,775.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,034.39 / $9,388.82 / $14,402.68	Facility		$8,034.39	$9,388.82	$14,402.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,354.80 / $7,861.90 / $8,933.98	Professional		$3,354.80	$7,861.90	$8,933.98
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,880.00 / $2,627.64 / $5,740.04	Facility		$1,880.00	$2,627.64	$5,740.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,880.00 / $2,744.42 / $13,868.10	Facility		$1,880.00	$2,744.42	$13,868.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,459.80 / $2,335.67 / $8,087.29	Professional		$1,459.80	$2,335.67	$8,087.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $4,379.39	Professional		$55.00	$85.00	$4,379.39
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,880.00 / $2,627.64 / $5,740.04	Facility		$1,880.00	$2,627.64	$5,740.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,874.04 / $6,961.75 / $9,764.33	Professional		$4,874.04	$6,961.75	$9,764.33
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,839.20 / $5,839.20 / $13,868.10	Facility		$5,839.20	$5,839.20	$13,868.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,547.39 / $14,598.00 / $14,598.00	Professional		$1,547.39	$14,598.00	$14,598.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,919.60 / $2,919.60 / $6,217.42	Professional		$2,919.60	$2,919.60	$6,217.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,919.60 / $2,919.60 / $15,941.02	Professional		$2,919.60	$2,919.60	$15,941.02
United Facility/Professional Professional Modifier Low / Median / High Price $1,459.80 / $1,751.76 / $5,434.54	Professional		$1,459.80	$1,751.76	$5,434.54