Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,748.03 / $7,277.72 / $65,513.48	Facility		$3,748.03	$7,277.72	$65,513.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,660.82 / $3,770.66 / $31,896.49	Professional		$3,660.82	$3,770.66	$31,896.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,576.04 / $6,772.54 / $8,163.65	Facility		$4,576.04	$6,772.54	$8,163.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,660.83 / $3,660.83 / $4,649.25	Professional		$3,660.83	$3,660.83	$4,649.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,012.01 / $5,012.01 / $5,857.33	Facility		$5,012.01	$5,012.01	$5,857.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,660.83 / $4,660.25 / $9,687.95	Facility		$3,660.83	$4,660.25	$9,687.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,632.59 / $5,257.47 / $5,974.40	Professional		$3,632.59	$5,257.47	$5,974.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,169.69 / $3,638.86 / $8,067.88	Facility		$2,169.69	$3,638.86	$8,067.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $5,458.29 / $7,321.66 / $7,321.66	Professional		$5,458.29	$7,321.66	$7,321.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,169.69 / $3,638.86 / $8,019.41	Facility		$2,169.69	$3,638.86	$8,019.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,638.86 / $3,638.86 / $7,321.66	Professional		$3,638.86	$3,638.86	$7,321.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $3,565.32	Professional		$65.00	$85.00	$3,565.32
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,169.69 / $3,638.86 / $8,067.88	Facility		$2,169.69	$3,638.86	$8,067.88
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $5,458.29 / $7,321.66 / $7,321.66	Professional		$5,458.29	$7,321.66	$7,321.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,660.83 / $3,660.84 / $11,859.59	Professional		$3,660.83	$3,660.84	$11,859.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,660.83 / $3,660.83 / $17,826.59	Facility		$3,660.83	$3,660.83	$17,826.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,660.83 / $3,660.83 / $3,660.83	Professional		$3,660.83	$3,660.83	$3,660.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,951.31 / $5,139.81 / $5,139.81	Professional		$2,951.31	$5,139.81	$5,139.81
United Facility/Professional Professional Modifier Low / Median / High Price $3,660.83 / $3,660.83 / $4,759.08	Professional		$3,660.83	$3,660.83	$4,759.08