Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,755.26 / $2,755.26 / $2,755.26	Facility		$2,755.26	$2,755.26	$2,755.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,731.60 / $2,479.73 / $3,250.19	Professional		$1,731.60	$2,479.73	$3,250.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,079.50 / $7,424.69 / $7,424.69	Facility		$4,079.50	$7,424.69	$7,424.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,793.91 / $3,793.94 / $5,507.28	Professional		$3,793.91	$3,793.94	$5,507.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $287.60 / $2,156.96 / $8,730.07	Facility		$287.60	$2,156.96	$8,730.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,672.64 / $2,672.64 / $12,386.30	Facility		$2,672.64	$2,672.64	$12,386.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,672.64 / $4,729.50 / $5,911.88	Professional		$2,672.64	$4,729.50	$5,911.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,496.69 / $3,120.86 / $4,895.35	Facility		$2,496.69	$3,120.86	$4,895.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,937.28 / $2,937.28 / $4,895.35	Professional		$2,937.28	$2,937.28	$4,895.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,496.69 / $4,959.47 / $19,176.53	Facility		$2,496.69	$4,959.47	$19,176.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,706.07 / $2,388.48 / $5,118.20	Professional		$1,706.07	$2,388.48	$5,118.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.87 / $55.00 / $3,227.58	Professional		$7.87	$55.00	$3,227.58
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,496.69 / $4,079.47 / $4,895.35	Facility		$2,496.69	$4,079.47	$4,895.35
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,937.28 / $2,937.28 / $4,895.35	Professional		$2,937.28	$2,937.28	$4,895.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $538.49 / $994.68 / $1,291.52	Professional		$538.49	$994.68	$1,291.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,672.64 / $7,921.30 / $19,176.53	Facility		$2,672.64	$7,921.30	$19,176.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,672.64 / $2,672.64 / $3,206.26	Professional		$2,672.64	$2,672.64	$3,206.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,250.47 / $4,250.47 / $4,250.47	Professional		$4,250.47	$4,250.47	$4,250.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,250.47 / $4,250.47 / $4,250.47	Professional		$4,250.47	$4,250.47	$4,250.47
United Facility/Professional Professional Modifier Low / Median / High Price $1,584.26 / $2,387.44 / $4,944.01	Professional		$1,584.26	$2,387.44	$4,944.01