Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,812.64 / $9,111.32 / $10,732.20	Facility		$4,812.64	$9,111.32	$10,732.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,827.46 / $10,493.60	Professional		$4,686.85	$4,827.46	$10,493.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,858.56 / $8,670.67 / $10,451.68	Facility		$5,858.56	$8,670.67	$10,451.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $5,952.29	Professional		$4,686.85	$4,686.85	$5,952.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6,416.74 / $6,416.74 / $7,498.96	Facility		$6,416.74	$6,416.74	$7,498.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,686.85 / $11,139.80 / $15,923.62	Facility		$4,686.85	$11,139.80	$15,923.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,776.10 / $6,981.11 / $7,933.08	Professional		$4,776.10	$6,981.11	$7,933.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,379.89 / $4,672.47 / $10,328.99	Facility		$3,379.89	$4,672.47	$10,328.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,054.44 / $9,373.70 / $9,373.70	Professional		$1,054.44	$9,373.70	$9,373.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,379.89 / $4,672.47 / $10,296.91	Facility		$3,379.89	$4,672.47	$10,296.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,672.47 / $4,672.47 / $9,373.70	Professional		$4,672.47	$4,672.47	$9,373.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $4,687.66	Professional		$65.00	$85.00	$4,687.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,379.89 / $4,672.47 / $10,328.99	Facility		$3,379.89	$4,672.47	$10,328.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,054.44 / $9,373.70 / $9,373.70	Professional		$1,054.44	$9,373.70	$9,373.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $6,267.95 / $14,399.00	Professional		$4,686.85	$6,267.95	$14,399.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $23,438.30 / $23,438.30 / $23,438.30	Facility		$23,438.30	$23,438.30	$23,438.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $4,686.85	Professional		$4,686.85	$4,686.85	$4,686.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,597.01 / $6,580.34 / $6,890.21	Professional		$4,597.01	$6,580.34	$6,890.21
United Facility/Professional Professional Modifier Low / Median / High Price $4,686.85 / $4,686.85 / $7,030.28	Professional		$4,686.85	$4,686.85	$7,030.28