Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,107.48 / $1,107.48 / $1,107.48	Facility		$1,107.48	$1,107.48	$1,107.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,018.28 / $1,107.48 / $1,933.90	Professional		$1,018.28	$1,107.48	$1,933.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,195.36 / $2,414.90 / $3,995.56	Facility		$2,195.36	$2,414.90	$3,995.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,898.76 / $2,041.68 / $2,700.29	Professional		$1,898.76	$2,041.68	$2,700.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,579.34 / $4,698.07 / $4,698.07	Facility		$1,579.34	$4,698.07	$4,698.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,304.10 / $4,846.85 / $9,162.95	Facility		$1,304.10	$4,846.85	$9,162.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $952.00 / $3,181.41 / $4,154.89	Professional		$952.00	$3,181.41	$4,154.89
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $644.82 / $1,661.22 / $2,524.66	Facility		$644.82	$1,661.22	$2,524.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,257.03 / $2,195.36 / $2,634.43	Professional		$1,257.03	$2,195.36	$2,634.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,107.48 / $2,195.36 / $10,402.94	Facility		$1,107.48	$2,195.36	$10,402.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $931.26 / $1,165.30 / $2,390.48	Professional		$931.26	$1,165.30	$2,390.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,481.57	Professional		$50.00	$70.00	$1,481.57
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $644.82 / $1,661.22 / $2,524.66	Facility		$644.82	$1,661.22	$2,524.66
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,257.03 / $2,195.36 / $2,634.43	Professional		$1,257.03	$2,195.36	$2,634.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,195.36 / $3,378.63 / $5,993.09	Professional		$2,195.36	$3,378.63	$5,993.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,304.10 / $4,287.82 / $10,402.94	Facility		$1,304.10	$4,287.82	$10,402.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $952.00 / $1,304.10 / $11,980.54	Professional		$952.00	$1,304.10	$11,980.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,195.36 / $2,195.36 / $2,195.36	Professional		$2,195.36	$2,195.36	$2,195.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,195.36 / $2,195.36 / $2,195.36	Professional		$2,195.36	$2,195.36	$2,195.36
United Facility/Professional Professional Modifier Low / Median / High Price $832.36 / $1,095.25 / $2,099.21	Professional		$832.36	$1,095.25	$2,099.21