Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,624.00 / $6,624.00 / $12,142.40	Facility		$6,624.00	$6,624.00	$12,142.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,250.39 / $5,244.00 / $6,624.00	Professional		$4,250.39	$5,244.00	$6,624.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,706.75 / $14,157.00 / $14,973.75	Facility		$11,706.75	$14,157.00	$14,973.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,200.00 / $2,200.00 / $23,557.67	Professional		$2,200.00	$2,200.00	$23,557.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13,830.30 / $13,830.30 / $13,830.30	Facility		$13,830.30	$13,830.30	$13,830.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15,136.11 / $17,687.74 / $27,133.45	Facility		$15,136.11	$17,687.74	$27,133.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,256.95 / $14,810.40 / $16,830.00	Professional		$6,256.95	$14,810.40	$16,830.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $4,250.39 / $6,624.00 / $19,057.50	Facility		$4,250.39	$6,624.00	$19,057.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $4,250.39 / $6,624.00 / $19,057.50	Facility		$4,250.39	$6,624.00	$19,057.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,750.00 / $3,300.00 / $16,961.18	Professional		$2,750.00	$3,300.00	$16,961.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $4,400.00	Professional		$50.00	$70.00	$4,400.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $4,250.39 / $6,624.00 / $19,057.50	Facility		$4,250.39	$6,624.00	$19,057.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $9,783.34 / $12,983.29 / $18,209.93	Professional		$9,783.34	$12,983.29	$18,209.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $11,000.00 / $25,482.60 / $25,482.60	Facility		$11,000.00	$25,482.60	$25,482.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,235.72 / $22,000.00 / $27,116.10	Professional		$5,235.72	$22,000.00	$27,116.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,500.00 / $5,500.00 / $11,712.49	Professional		$5,500.00	$5,500.00	$11,712.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,500.00 / $15,823.17 / $30,030.00	Professional		$5,500.00	$15,823.17	$30,030.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,390.85 / $3,300.00 / $14,586.50	Professional		$2,390.85	$3,300.00	$14,586.50