Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,156.38 / $1,156.38 / $1,156.38	Facility		$1,156.38	$1,156.38	$1,156.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $726.77 / $1,040.74 / $1,364.12	Professional		$726.77	$1,040.74	$1,364.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,702.90 / $3,099.28 / $3,099.28	Facility		$1,702.90	$3,099.28	$3,099.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,583.66 / $1,583.70 / $2,298.86	Professional		$1,583.66	$1,583.70	$2,298.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $120.05 / $900.36 / $3,644.12	Facility		$120.05	$900.36	$3,644.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,116.58 / $1,116.58 / $5,170.18	Facility		$1,116.58	$1,116.58	$5,170.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,116.58 / $1,974.00 / $2,467.50	Professional		$1,116.58	$1,974.00	$2,467.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,063.46 / $1,329.32 / $2,043.43	Facility		$1,063.46	$1,329.32	$2,043.43
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,251.13 / $1,251.13 / $2,043.43	Professional		$1,251.13	$1,251.13	$2,043.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,063.46 / $2,081.48 / $8,011.55	Facility		$1,063.46	$2,081.48	$8,011.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $716.07 / $1,002.49 / $2,148.19	Professional		$716.07	$1,002.49	$2,148.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $3.30 / $55.00 / $1,355.67	Professional		$3.30	$55.00	$1,355.67
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,063.46 / $1,702.86 / $2,043.43	Facility		$1,063.46	$1,702.86	$2,043.43
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,251.13 / $1,251.13 / $2,043.43	Professional		$1,251.13	$1,251.13	$2,043.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $224.78 / $414.91 / $538.73	Professional		$224.78	$414.91	$538.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,116.58 / $3,306.52 / $8,011.55	Facility		$1,116.58	$3,306.52	$8,011.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,116.58 / $1,116.58 / $1,338.37	Professional		$1,116.58	$1,116.58	$1,338.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,793.08 / $1,793.08 / $1,793.08	Professional		$1,793.08	$1,793.08	$1,793.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,793.08 / $1,793.08 / $1,793.08	Professional		$1,793.08	$1,793.08	$1,793.08
United Facility/Professional Professional Modifier Low / Median / High Price $661.30 / $923.00 / $2,075.08	Professional		$661.30	$923.00	$2,075.08