Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,117.64 / $9,688.73 / $11,412.30	Facility		$5,117.64	$9,688.73	$11,412.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $5,323.28 / $10,407.00	Professional		$5,168.22	$5,323.28	$10,407.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,460.29 / $9,561.23 / $11,525.15	Facility		$6,460.29	$9,561.23	$11,525.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $5,168.22 / $6,563.65	Professional		$5,168.22	$5,168.22	$6,563.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,075.78 / $7,075.78 / $8,269.17	Facility		$7,075.78	$7,075.78	$8,269.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,168.22 / $11,866.48 / $16,962.37	Facility		$5,168.22	$11,866.48	$16,962.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $7,450.80 / $8,466.81	Professional		$5,168.22	$7,450.80	$8,466.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,389.16 / $4,968.58 / $11,389.69	Facility		$3,389.16	$4,968.58	$11,389.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $344.98 / $10,336.45 / $10,336.45	Professional		$344.98	$10,336.45	$10,336.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,389.16 / $4,968.58 / $10,949.15	Facility		$3,389.16	$4,968.58	$10,949.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,968.58 / $4,968.58 / $10,336.45	Professional		$4,968.58	$4,968.58	$10,336.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $4,968.58	Professional		$65.00	$85.00	$4,968.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,389.16 / $4,968.58 / $11,389.69	Facility		$3,389.16	$4,968.58	$11,389.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $344.98 / $10,336.45 / $10,336.45	Professional		$344.98	$10,336.45	$10,336.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $6,046.65 / $15,674.00	Professional		$5,168.22	$6,046.65	$15,674.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $24,842.90 / $24,842.90 / $24,842.90	Facility		$24,842.90	$24,842.90	$24,842.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $5,168.22 / $5,168.22	Professional		$5,168.22	$5,168.22	$5,168.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,609.68 / $7,256.19 / $7,256.19	Professional		$4,609.68	$7,256.19	$7,256.19
United Facility/Professional Professional Modifier Low / Median / High Price $5,168.22 / $5,168.22 / $7,076.34	Professional		$5,168.22	$5,168.22	$7,076.34