Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,502.79 / $4,881.39 / $5,606.04	Facility		$2,502.79	$4,881.39	$5,606.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,454.19 / $2,915.87	Professional		$2,429.89	$2,454.19	$2,915.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,037.36 / $4,495.30 / $5,418.65	Facility		$3,037.36	$4,495.30	$5,418.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,429.89 / $3,280.35	Professional		$2,429.89	$2,429.89	$3,280.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,326.74 / $3,596.24 / $3,887.82	Facility		$3,326.74	$3,596.24	$3,887.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,424.67 / $3,094.69 / $6,503.94	Facility		$2,424.67	$3,094.69	$6,503.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,636.82 / $4,119.31	Professional		$2,429.89	$2,636.82	$4,119.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,235.38 / $2,440.69 / $2,678.50	Facility		$2,235.38	$2,440.69	$2,678.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $3,661.05 / $4,859.78 / $4,859.78	Professional		$3,661.05	$4,859.78	$4,859.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,235.38 / $2,440.69 / $2,698.94	Facility		$2,235.38	$2,440.69	$2,698.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,440.69 / $2,717.01 / $10,655.19	Professional		$2,440.69	$2,717.01	$10,655.19
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 $2,147.08 / $2,440.69 / $2,678.50	Facility		$2,147.08	$2,440.69	$2,678.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $3,661.05 / $4,859.78 / $4,859.78	Professional		$3,661.05	$4,859.78	$4,859.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $3,203.52 / $7,461.00	Professional		$2,429.89	$3,203.52	$7,461.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,503.21 / $12,207.45 / $12,207.45	Facility		$2,503.21	$12,207.45	$12,207.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $4,439.66 / $10,655.19	Professional		$2,429.89	$4,439.66	$10,655.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,352.58 / $3,411.57 / $3,521.54	Professional		$2,352.58	$3,411.57	$3,521.54
United Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,575.67 / $3,110.73	Professional		$2,429.89	$2,575.67	$3,110.73