Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,500.00 / $5,625.00 / $8,362.50	Facility		$4,500.00	$5,625.00	$8,362.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,887.50 / $3,562.50 / $5,625.00	Professional		$2,887.50	$3,562.50	$5,625.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,062.50 / $9,750.00 / $10,312.50	Facility		$8,062.50	$9,750.00	$10,312.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $2,920.30 / $16,062.04	Professional		$1,500.00	$2,920.30	$16,062.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9,164.66 / $9,164.66 / $9,525.00	Facility		$9,164.66	$9,164.66	$9,525.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,319.62 / $12,059.30 / $18,499.27	Facility		$10,319.62	$12,059.30	$18,499.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,309.24 / $10,098.00 / $11,475.00	Professional		$4,309.24	$10,098.00	$11,475.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,887.50 / $4,500.00 / $13,125.00	Facility		$2,887.50	$4,500.00	$13,125.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,375.00 / $4,500.00 / $13,125.00	Facility		$3,375.00	$4,500.00	$13,125.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,606.17 / $2,250.00 / $11,564.44	Professional		$1,606.17	$2,250.00	$11,564.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,875.00	Professional		$50.00	$70.00	$1,875.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,887.50 / $4,500.00 / $13,125.00	Facility		$2,887.50	$4,500.00	$13,125.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,569.78 / $8,941.68 / $12,541.31	Professional		$5,569.78	$8,941.68	$12,541.31
Quartz Facility/Professional Facility Modifier Low / Median / High Price $7,500.00 / $17,812.50 / $17,812.50	Facility		$7,500.00	$17,812.50	$17,812.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,437.50 / $18,750.00 / $18,750.00	Professional		$5,437.50	$18,750.00	$18,750.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,190.23 / $2,190.23 / $7,985.79	Professional		$2,190.23	$2,190.23	$7,985.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,190.23 / $10,738.63 / $20,475.00	Professional		$2,190.23	$10,738.63	$20,475.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,575.00 / $2,250.00 / $6,750.00	Professional		$1,575.00	$2,250.00	$6,750.00