Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,311.43 / $1,311.43 / $1,311.43	Facility		$1,311.43	$1,311.43	$1,311.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $838.98 / $1,201.75 / $1,574.54	Professional		$838.98	$1,201.75	$1,574.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,805.30 / $3,285.65 / $3,285.65	Facility		$1,805.30	$3,285.65	$3,285.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,678.91 / $1,678.93 / $2,437.12	Professional		$1,678.91	$1,678.93	$2,437.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $127.27 / $954.51 / $3,863.30	Facility		$127.27	$954.51	$3,863.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,217.05 / $1,217.05 / $4,952.56	Facility		$1,217.05	$1,217.05	$4,952.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,034.49 / $2,148.75 / $2,685.94	Professional		$1,034.49	$2,148.75	$2,685.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,417.27 / $1,805.28 / $2,338.48	Facility		$1,417.27	$1,805.28	$2,338.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,667.38 / $1,667.38 / $2,166.34	Professional		$1,667.38	$1,667.38	$2,166.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,417.27 / $2,360.57 / $8,728.48	Facility		$1,417.27	$2,360.57	$8,728.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $902.07 / $1,230.08 / $2,402.28	Professional		$902.07	$1,230.08	$2,402.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $3.37 / $55.00 / $1,382.70	Professional		$3.37	$55.00	$1,382.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,417.27 / $1,805.28 / $2,338.48	Facility		$1,417.27	$1,805.28	$2,338.48
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,667.38 / $1,667.38 / $2,166.34	Professional		$1,667.38	$1,667.38	$2,166.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $238.30 / $429.90 / $558.19	Professional		$238.30	$429.90	$558.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,217.05 / $3,505.40 / $8,728.48	Facility		$1,217.05	$3,505.40	$8,728.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,217.05 / $1,217.05 / $1,629.32	Professional		$1,217.05	$1,217.05	$1,629.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,261.52 / $2,261.52 / $2,261.52	Professional		$2,261.52	$2,261.52	$2,261.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,261.52 / $2,261.52 / $2,261.52	Professional		$2,261.52	$2,261.52	$2,261.52
United Facility/Professional Professional Modifier Low / Median / High Price $800.76 / $1,261.11 / $2,261.52	Professional		$800.76	$1,261.11	$2,261.52