Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,000.00 / $6,000.00 / $6,000.00	Facility		$6,000.00	$6,000.00	$6,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,850.00 / $5,000.00 / $6,000.00	Professional		$3,850.00	$5,000.00	$6,000.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,750.00 / $13,000.00 / $13,750.00	Facility		$10,750.00	$13,000.00	$13,750.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,000.00 / $2,000.00 / $21,416.06	Professional		$2,000.00	$2,000.00	$21,416.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7,608.34 / $7,608.34 / $7,608.34	Facility		$7,608.34	$7,608.34	$7,608.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13,760.10 / $16,079.77 / $24,666.78	Facility		$13,760.10	$16,079.77	$24,666.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,917.60 / $13,464.00 / $15,300.00	Professional		$5,917.60	$13,464.00	$15,300.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $3,850.00 / $6,000.00 / $17,500.00	Facility		$3,850.00	$6,000.00	$17,500.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,850.00 / $6,000.00 / $17,500.00	Facility		$3,850.00	$6,000.00	$17,500.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,500.00 / $3,000.00 / $15,419.25	Professional		$2,500.00	$3,000.00	$15,419.25
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 $3,850.00 / $6,000.00 / $17,500.00	Facility		$3,850.00	$6,000.00	$17,500.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8,347.32 / $11,922.76 / $16,722.46	Professional		$8,347.32	$11,922.76	$16,722.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $10,000.00 / $23,750.00 / $23,750.00	Facility		$10,000.00	$23,750.00	$23,750.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20,000.00 / $20,000.00 / $24,900.00	Professional		$20,000.00	$20,000.00	$24,900.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,000.00 / $5,000.00 / $10,647.72	Professional		$5,000.00	$5,000.00	$10,647.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,000.00 / $26,250.00 / $27,300.00	Professional		$5,000.00	$26,250.00	$27,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,100.00 / $3,000.00 / $9,307.00	Professional		$2,100.00	$3,000.00	$9,307.00