Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,739.20 / $4,674.00 / $6,948.68	Facility		$3,739.20	$4,674.00	$6,948.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,399.32 / $2,960.20 / $4,751.10	Professional		$2,399.32	$2,960.20	$4,751.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,699.40 / $8,101.60 / $8,569.00	Facility		$6,699.40	$8,101.60	$8,569.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,246.40 / $3,116.00 / $13,346.48	Professional		$1,246.40	$3,116.00	$13,346.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,615.22 / $7,615.22 / $7,914.64	Facility		$7,615.22	$7,615.22	$7,914.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,575.06 / $10,020.62 / $15,371.91	Facility		$8,575.06	$10,020.62	$15,371.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,580.71 / $8,390.77 / $9,534.95	Professional		$3,580.71	$8,390.77	$9,534.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,399.32 / $3,739.20 / $10,906.00	Facility		$2,399.32	$3,739.20	$10,906.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,804.40 / $3,739.20 / $10,906.00	Facility		$2,804.40	$3,739.20	$10,906.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,562.87 / $1,875.44 / $9,609.28	Professional		$1,562.87	$1,875.44	$9,609.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,116.00	Professional		$50.00	$70.00	$3,116.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,399.32 / $3,739.20 / $10,906.00	Facility		$2,399.32	$3,739.20	$10,906.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,962.00 / $7,598.51 / $10,420.98	Professional		$5,962.00	$7,598.51	$10,420.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,232.00 / $14,801.00 / $14,801.00	Facility		$6,232.00	$14,801.00	$14,801.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,518.20 / $15,580.00 / $15,580.00	Professional		$4,518.20	$15,580.00	$15,580.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,344.30 / $2,344.30 / $6,635.66	Professional		$2,344.30	$2,344.30	$6,635.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,344.30 / $9,090.40 / $17,013.36	Professional		$2,344.30	$9,090.40	$17,013.36
United Facility/Professional Facility Modifier Low / Median / High Price $3,116.00 / $3,116.00 / $3,116.00	Facility		$3,116.00	$3,116.00	$3,116.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,354.53 / $1,875.44 / $6,564.03	Professional		$1,354.53	$1,875.44	$6,564.03