Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,782.23 / $3,474.20 / $10,339.53	Facility		$1,782.23	$3,474.20	$10,339.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,730.31 / $2,131.57 / $10,591.82	Professional		$1,730.31	$2,131.57	$10,591.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,162.90 / $3,201.09 / $3,858.61	Facility		$2,162.90	$3,201.09	$3,858.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,730.32 / $2,197.50	Professional		$1,730.32	$1,730.32	$2,197.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,560.87 / $3,171.51 / $3,171.51	Facility		$2,560.87	$3,171.51	$3,171.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,730.32 / $2,460.16 / $4,500.58	Facility		$1,730.32	$2,460.16	$4,500.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,701.83 / $2,440.12 / $2,772.86	Professional		$1,701.83	$2,440.12	$2,772.86
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $306.13 / $1,730.32 / $1,737.10	Facility		$306.13	$1,730.32	$1,737.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $317.99 / $3,460.64 / $3,460.64	Professional		$317.99	$3,460.64	$3,460.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $306.13 / $1,737.10 / $2,711.70	Facility		$306.13	$1,737.10	$2,711.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,737.10 / $1,933.76 / $3,460.64	Professional		$1,737.10	$1,933.76	$3,460.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $1,670.30	Professional		$65.00	$85.00	$1,670.30
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $306.13 / $1,730.32 / $1,737.10	Facility		$306.13	$1,730.32	$1,737.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $317.99 / $3,460.64 / $3,460.64	Professional		$317.99	$3,460.64	$3,460.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,921.73 / $5,153.00	Professional		$1,730.32	$1,921.73	$5,153.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,730.32 / $1,730.32 / $8,351.50	Facility		$1,730.32	$1,730.32	$8,351.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,730.32 / $1,730.32	Professional		$1,730.32	$1,730.32	$1,730.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,486.23 / $2,429.37 / $2,429.37	Professional		$1,486.23	$2,429.37	$2,429.37
United Facility/Professional Professional Modifier Low / Median / High Price $1,730.32 / $1,926.21 / $2,422.44	Professional		$1,730.32	$1,926.21	$2,422.44