Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,179.81 / $4,226.47 / $6,435.78	Facility		$2,179.81	$4,226.47	$6,435.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,906.34 / $4,067.00	Professional		$2,116.32	$2,906.34	$4,067.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,645.40 / $3,915.19 / $4,719.39	Facility		$2,645.40	$3,915.19	$4,719.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,116.32 / $2,687.72	Professional		$2,116.32	$2,116.32	$2,687.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,897.44 / $2,897.44 / $3,386.11	Facility		$2,897.44	$2,897.44	$3,386.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,116.32 / $3,153.18 / $5,768.40	Facility		$2,116.32	$3,153.18	$5,768.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $3,152.17 / $3,582.01	Professional		$2,116.32	$3,152.17	$3,582.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,073.44 / $2,113.23 / $2,116.32	Facility		$1,073.44	$2,113.23	$2,116.32
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $588.95 / $4,232.64 / $4,232.64	Professional		$588.95	$4,232.64	$4,232.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,073.44 / $2,113.23 / $2,113.23	Facility		$1,073.44	$2,113.23	$2,113.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,113.23 / $2,113.23 / $4,232.64	Professional		$2,113.23	$2,113.23	$4,232.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $85.00 / $2,078.71	Professional		$65.00	$85.00	$2,078.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,073.44 / $2,113.23 / $2,116.32	Facility		$1,073.44	$2,113.23	$2,116.32
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $588.95 / $4,232.64 / $4,232.64	Professional		$588.95	$4,232.64	$4,232.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,832.18 / $6,393.00	Professional		$2,116.32	$2,832.18	$6,393.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,393.54 / $10,393.54 / $10,393.54	Facility		$10,393.54	$10,393.54	$10,393.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,116.32 / $2,116.32	Professional		$2,116.32	$2,116.32	$2,116.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,066.98 / $2,971.31 / $3,074.98	Professional		$2,066.98	$2,971.31	$3,074.98
United Facility/Professional Professional Modifier Low / Median / High Price $2,116.32 / $2,116.32 / $2,897.67	Professional		$2,116.32	$2,116.32	$2,897.67