Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,886.04 / $7,357.06 / $8,665.87	Facility		$3,886.04	$7,357.06	$8,665.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,817.28 / $3,931.80 / $6,481.76	Professional		$3,817.28	$3,931.80	$6,481.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,771.60 / $7,061.97 / $8,512.53	Facility		$4,771.60	$7,061.97	$8,512.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,817.28 / $3,817.28 / $4,847.93	Professional		$3,817.28	$3,817.28	$4,847.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,226.21 / $5,226.21 / $6,107.65	Facility		$5,226.21	$5,226.21	$6,107.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,554.46 / $6,447.50 / $9,216.28	Facility		$3,554.46	$6,447.50	$9,216.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,679.38 / $3,758.23 / $4,465.27	Professional		$3,679.38	$3,758.23	$4,465.27
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,772.85 / $3,772.85 / $8,412.18	Facility		$3,772.85	$3,772.85	$8,412.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $5,659.28 / $7,634.56 / $7,634.56	Professional		$5,659.28	$7,634.56	$7,634.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,772.85 / $3,772.85 / $8,314.52	Facility		$3,772.85	$3,772.85	$8,314.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,772.85 / $4,199.97 / $7,634.56	Professional		$3,772.85	$4,199.97	$7,634.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $8,554.74	Professional		$50.00	$85.00	$8,554.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $3,772.85 / $3,772.85 / $8,412.18	Facility		$3,772.85	$3,772.85	$8,412.18
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $5,659.28 / $7,634.56 / $7,634.56	Professional		$5,659.28	$7,634.56	$7,634.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,817.27 / $3,817.27 / $5,941.98	Professional		$3,817.27	$3,817.27	$5,941.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $17,530.20 / $17,530.20 / $17,530.20	Facility		$17,530.20	$17,530.20	$17,530.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,817.28 / $3,817.28 / $3,817.28	Professional		$3,817.28	$3,817.28	$3,817.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,359.46 / $5,359.46 / $5,359.46	Professional		$5,359.46	$5,359.46	$5,359.46
United Facility/Professional Professional Modifier Low / Median / High Price $3,817.28 / $4,249.43 / $5,344.19	Professional		$3,817.28	$4,249.43	$5,344.19