Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,076.92 / $2,964.83 / $4,539.95	Facility		$2,076.92	$2,964.83	$4,539.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,076.92 / $6,049.88	Professional		$2,016.42	$2,076.92	$6,049.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,730.38 / $4,335.30 / $4,496.62	Facility		$3,730.38	$4,335.30	$4,496.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $2,560.85	Professional		$2,016.42	$2,016.42	$2,560.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,760.66 / $2,760.66 / $3,226.27	Facility		$2,760.66	$2,760.66	$3,226.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,016.42 / $4,717.05 / $6,742.72	Facility		$2,016.42	$4,717.05	$6,742.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $5,018.09 / $5,702.38	Professional		$2,016.42	$5,018.09	$5,702.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,539.08 / $1,976.55 / $4,443.81	Facility		$1,539.08	$1,976.55	$4,443.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,539.08 / $1,976.55 / $4,356.14	Facility		$1,539.08	$1,976.55	$4,356.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,976.55 / $1,976.55 / $2,569.52	Professional		$1,976.55	$1,976.55	$2,569.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $1,925.23 / $2,016.42	Professional		$65.00	$1,925.23	$2,016.42
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,539.08 / $1,976.55 / $4,443.81	Facility		$1,539.08	$1,976.55	$4,443.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,566.77 / $6,569.20	Professional		$2,016.42	$2,566.77	$6,569.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $9,626.15 / $9,626.15 / $9,626.15	Facility		$9,626.15	$9,626.15	$9,626.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $2,016.42	Professional		$2,016.42	$2,016.42	$2,016.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,093.50 / $2,831.05 / $2,831.05	Professional		$2,093.50	$2,831.05	$2,831.05
United Facility/Professional Facility Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $2,016.42	Facility		$2,016.42	$2,016.42	$2,016.42
United Facility/Professional Professional Modifier Low / Median / High Price $2,016.42 / $2,016.42 / $2,621.35	Professional		$2,016.42	$2,016.42	$2,621.35