Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,721.05 / $1,721.05 / $1,721.05	Facility		$1,721.05	$1,721.05	$1,721.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,086.81 / $1,548.94 / $2,035.67	Professional		$1,086.81	$1,548.94	$2,035.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,582.80 / $4,700.70 / $4,700.70	Facility		$2,582.80	$4,700.70	$4,700.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,402.00 / $2,402.28 / $3,486.78	Professional		$2,402.00	$2,402.28	$3,486.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $185.81 / $1,393.66 / $5,527.83	Facility		$185.81	$1,393.66	$5,527.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,460.50 / $1,460.50 / $6,942.23	Facility		$1,460.50	$1,460.50	$6,942.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,460.50 / $2,994.75 / $3,743.44	Professional		$1,460.50	$2,994.75	$3,743.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $707.15 / $1,848.76 / $3,097.89	Facility		$707.15	$1,848.76	$3,097.89
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,479.01 / $1,479.01 / $3,099.72	Professional		$1,479.01	$1,479.01	$3,099.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $707.15 / $3,099.72 / $12,056.48	Facility		$707.15	$3,099.72	$12,056.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,012.76 / $1,447.47 / $2,877.01	Professional		$1,012.76	$1,447.47	$2,877.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.16 / $55.00 / $2,583.10	Professional		$5.16	$55.00	$2,583.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $707.15 / $2,040.00 / $3,097.89	Facility		$707.15	$2,040.00	$3,097.89
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,479.01 / $1,479.01 / $3,099.72	Professional		$1,479.01	$1,479.01	$3,099.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $340.93 / $516.66 / $670.85	Professional		$340.93	$516.66	$670.85
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,460.50 / $5,045.12 / $12,056.48	Facility		$1,460.50	$5,045.12	$12,056.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,460.50 / $1,460.50 / $1,916.91	Professional		$1,460.50	$1,460.50	$1,916.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,583.10 / $2,583.10 / $2,583.10	Professional		$2,583.10	$2,583.10	$2,583.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,583.10 / $2,583.10 / $2,583.10	Professional		$2,583.10	$2,583.10	$2,583.10
United Facility/Professional Professional Modifier Low / Median / High Price $912.82 / $1,288.68 / $2,583.10	Professional		$912.82	$1,288.68	$2,583.10