Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,888.00 / $4,860.00 / $7,225.20	Facility		$3,888.00	$4,860.00	$7,225.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,494.80 / $3,240.00 / $3,888.00	Professional		$2,494.80	$3,240.00	$3,888.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,966.00 / $8,424.00 / $8,910.00	Facility		$6,966.00	$8,424.00	$8,910.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,296.00 / $2,840.75 / $13,877.60	Professional		$1,296.00	$2,840.75	$13,877.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,918.26 / $7,918.26 / $8,229.60	Facility		$7,918.26	$7,918.26	$8,229.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,916.58 / $10,419.73 / $15,984.14	Facility		$8,916.58	$10,419.73	$15,984.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,722.78 / $8,724.67 / $9,914.40	Professional		$3,722.78	$8,724.67	$9,914.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,494.80 / $3,888.00 / $11,340.00	Facility		$2,494.80	$3,888.00	$11,340.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,916.00 / $3,888.00 / $11,340.00	Facility		$2,916.00	$3,888.00	$11,340.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,420.38 / $1,944.00 / $9,991.67	Professional		$1,420.38	$1,944.00	$9,991.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,592.00	Professional		$50.00	$70.00	$2,592.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,494.80 / $3,888.00 / $11,340.00	Facility		$2,494.80	$3,888.00	$11,340.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,417.82 / $7,901.41 / $10,836.39	Professional		$5,417.82	$7,901.41	$10,836.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $6,480.00 / $15,390.00 / $15,390.00	Facility		$6,480.00	$15,390.00	$15,390.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,698.00 / $16,200.00 / $16,200.00	Professional		$4,698.00	$16,200.00	$16,200.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,130.56 / $2,130.56 / $6,899.72	Professional		$2,130.56	$2,130.56	$6,899.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,130.56 / $8,255.83 / $17,690.40	Professional		$2,130.56	$8,255.83	$17,690.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,360.80 / $1,944.00 / $5,965.58	Professional		$1,360.80	$1,944.00	$5,965.58