Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,025.49 / $1,025.49 / $1,025.49	Facility		$1,025.49	$1,025.49	$1,025.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $873.33 / $1,025.49 / $1,658.61	Professional		$873.33	$1,025.49	$1,658.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,032.83 / $2,236.11 / $3,699.75	Facility		$2,032.83	$2,236.11	$3,699.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,758.19 / $1,890.53 / $2,500.38	Professional		$1,758.19	$1,890.53	$2,500.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,462.41 / $4,350.26 / $4,350.26	Facility		$1,462.41	$4,350.26	$4,350.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,108.41 / $4,488.22 / $8,485.56	Facility		$1,108.41	$4,488.22	$8,485.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $809.14 / $2,945.63 / $3,847.30	Professional		$809.14	$2,945.63	$3,847.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $562.66 / $1,538.24 / $2,337.75	Facility		$562.66	$1,538.24	$2,337.75
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,163.94 / $2,032.83 / $2,439.40	Professional		$1,163.94	$2,032.83	$2,439.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $974.00 / $2,032.83 / $9,247.12	Facility		$974.00	$2,032.83	$9,247.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $809.85 / $1,036.73 / $2,213.50	Professional		$809.85	$1,036.73	$2,213.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,371.85	Professional		$50.00	$70.00	$1,371.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $562.66 / $1,538.24 / $2,337.75	Facility		$562.66	$1,538.24	$2,337.75
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,163.94 / $2,032.83 / $2,439.40	Professional		$1,163.94	$2,032.83	$2,439.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,032.83 / $3,128.46 / $5,229.28	Professional		$2,032.83	$3,128.46	$5,229.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,108.41 / $3,970.38 / $9,247.12	Facility		$1,108.41	$3,970.38	$9,247.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $809.14 / $1,108.41 / $11,100.47	Professional		$809.14	$1,108.41	$11,100.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,032.83 / $2,032.83 / $2,032.83	Professional		$2,032.83	$2,032.83	$2,032.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,032.83 / $2,032.83 / $2,032.83	Professional		$2,032.83	$2,032.83	$2,032.83
United Facility/Professional Professional Modifier Low / Median / High Price $726.31 / $1,014.16 / $1,943.80	Professional		$726.31	$1,014.16	$1,943.80