Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,012.25 / $3,012.25 / $3,012.25	Facility		$3,012.25	$3,012.25	$3,012.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,932.86 / $2,359.60 / $3,012.25	Professional		$1,932.86	$2,359.60	$3,012.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,396.95 / $6,526.55 / $6,903.08	Facility		$5,396.95	$6,526.55	$6,903.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $1,500.00 / $10,386.02	Professional		$1,500.00	$1,500.00	$10,386.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,819.42 / $3,819.42 / $3,819.42	Facility		$3,819.42	$3,819.42	$3,819.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,907.99 / $8,072.53 / $12,383.46	Facility		$6,907.99	$8,072.53	$12,383.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,970.92 / $6,759.49 / $7,681.24	Professional		$2,970.92	$6,759.49	$7,681.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,932.86 / $3,012.25 / $8,785.74	Facility		$1,932.86	$3,012.25	$8,785.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,932.86 / $3,012.25 / $8,785.74	Facility		$1,932.86	$3,012.25	$8,785.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,394.56 / $1,673.47 / $8,601.23	Professional		$1,394.56	$1,673.47	$8,601.23
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 $1,932.86 / $3,012.25 / $8,785.74	Facility		$1,932.86	$3,012.25	$8,785.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,190.39 / $5,985.29 / $8,394.77	Professional		$4,190.39	$5,985.29	$8,394.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $5,020.42 / $11,923.50 / $11,923.50	Facility		$5,020.42	$11,923.50	$11,923.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10,040.84 / $12,551.05 / $12,551.05	Professional		$10,040.84	$12,551.05	$12,551.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,345.60 / $5,345.60 / $5,345.60	Professional		$5,345.60	$5,345.60	$5,345.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $7,295.21 / $13,705.75 / $13,705.75	Professional		$7,295.21	$13,705.75	$13,705.75
United Facility/Professional Professional Modifier Low / Median / High Price $1,255.10 / $1,673.47 / $6,879.23	Professional		$1,255.10	$1,673.47	$6,879.23