Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,647.60 / $5,809.50 / $8,636.79	Facility		$4,647.60	$5,809.50	$8,636.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,982.21 / $3,873.00 / $4,647.60	Professional		$2,982.21	$3,873.00	$4,647.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,326.95 / $10,069.79 / $10,650.75	Facility		$8,326.95	$10,069.79	$10,650.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,549.20 / $3,419.42 / $16,588.88	Professional		$1,549.20	$3,419.42	$16,588.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,873.00 / $9,465.25 / $9,837.42	Facility		$3,873.00	$9,465.25	$9,837.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,873.00 / $3,873.00 / $4,647.60	Professional		$3,873.00	$3,873.00	$4,647.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,658.45 / $12,455.24 / $19,106.66	Facility		$10,658.45	$12,455.24	$19,106.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,450.49 / $10,429.20 / $11,851.38	Professional		$4,450.49	$10,429.20	$11,851.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,982.21 / $4,647.60 / $13,555.50	Facility		$2,982.21	$4,647.60	$13,555.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,485.70 / $4,647.60 / $13,555.50	Facility		$3,485.70	$4,647.60	$13,555.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,683.59 / $2,323.80 / $11,943.75	Professional		$1,683.59	$2,323.80	$11,943.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,062.40	Professional		$50.00	$70.00	$2,062.40
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,982.21 / $4,647.60 / $13,555.50	Facility		$2,982.21	$4,647.60	$13,555.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $6,536.98 / $9,444.29 / $12,952.39	Professional		$6,536.98	$9,444.29	$12,952.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,746.00 / $18,396.75 / $18,396.75	Facility		$7,746.00	$18,396.75	$18,396.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,615.85 / $19,365.00 / $19,365.00	Professional		$5,615.85	$19,365.00	$19,365.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,582.52 / $2,582.52 / $8,247.71	Professional		$2,582.52	$2,582.52	$8,247.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,582.52 / $2,582.52 / $21,146.58	Professional		$2,582.52	$2,582.52	$21,146.58
United Facility/Professional Facility Modifier Low / Median / High Price $3,098.40 / $3,098.40 / $8,404.41	Facility		$3,098.40	$3,098.40	$8,404.41
United Facility/Professional Professional Modifier Low / Median / High Price $1,626.66 / $2,323.80 / $6,971.40	Professional		$1,626.66	$2,323.80	$6,971.40