Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,140.00 / $1,140.00 / $1,140.00	Facility		$1,140.00	$1,140.00	$1,140.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $731.50 / $902.50 / $1,140.00	Professional		$731.50	$902.50	$1,140.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,042.50 / $2,470.00 / $2,612.50	Facility		$2,042.50	$2,470.00	$2,612.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.00 / $807.50 / $3,930.63	Professional		$380.00	$807.50	$3,930.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,445.58 / $2,321.71 / $2,321.71	Facility		$1,445.58	$2,321.71	$2,321.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,614.15 / $3,054.84 / $4,686.20	Facility		$2,614.15	$3,054.84	$4,686.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,124.31 / $2,558.16 / $2,907.00	Professional		$1,124.31	$2,558.16	$2,907.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $731.50 / $1,140.00 / $3,325.00	Facility		$731.50	$1,140.00	$3,325.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $950.00 / $950.00 / $950.00	Professional		$950.00	$950.00	$950.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $855.00 / $1,140.00 / $3,325.00	Facility		$855.00	$1,140.00	$3,325.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $608.29 / $2,929.66	Professional		$475.00	$608.29	$2,929.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $731.50 / $1,140.00 / $3,325.00	Facility		$731.50	$1,140.00	$3,325.00
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $950.00 / $950.00 / $950.00	Professional		$950.00	$950.00	$950.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,388.32 / $2,261.48 / $3,177.25	Professional		$1,388.32	$2,261.48	$3,177.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,900.00 / $4,512.50 / $4,512.50	Facility		$1,900.00	$4,512.50	$4,512.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,800.00 / $4,750.00 / $4,750.00	Professional		$3,800.00	$4,750.00	$4,750.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,023.07 / $2,023.07 / $2,023.07	Professional		$2,023.07	$2,023.07	$2,023.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,760.90 / $5,187.00 / $5,187.00	Professional		$2,760.90	$5,187.00	$5,187.00
United Facility/Professional Professional Modifier Low / Median / High Price $427.50 / $608.29 / $2,340.05	Professional		$427.50	$608.29	$2,340.05