Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,243.75 / $1,243.75 / $1,243.75	Facility		$1,243.75	$1,243.75	$1,243.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,008.73 / $1,243.75 / $1,915.76	Professional		$1,008.73	$1,243.75	$1,915.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,465.48 / $2,712.03 / $4,487.17	Facility		$2,465.48	$2,712.03	$4,487.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,132.39 / $2,292.90 / $3,032.54	Professional		$2,132.39	$2,292.90	$3,032.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,773.67 / $5,276.13 / $5,276.13	Facility		$1,773.67	$5,276.13	$5,276.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,327.28 / $5,443.97 / $10,290.99	Facility		$1,327.28	$5,443.97	$10,290.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $968.91 / $3,572.81 / $4,666.13	Professional		$968.91	$3,572.81	$4,666.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $684.12 / $1,865.63 / $2,835.30	Facility		$684.12	$1,865.63	$2,835.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,411.67 / $2,465.48 / $2,958.58	Professional		$1,411.67	$2,465.48	$2,958.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,184.24 / $2,465.48 / $11,068.57	Facility		$1,184.24	$2,465.48	$11,068.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $979.78 / $1,236.32 / $2,684.61	Professional		$979.78	$1,236.32	$2,684.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,663.83	Professional		$50.00	$70.00	$1,663.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $684.12 / $1,865.63 / $2,835.30	Facility		$684.12	$1,865.63	$2,835.30
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,411.67 / $2,465.48 / $2,958.58	Professional		$1,411.67	$2,465.48	$2,958.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,465.48 / $3,794.29 / $6,358.44	Professional		$2,465.48	$3,794.29	$6,358.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,327.28 / $4,815.39 / $11,068.57	Facility		$1,327.28	$4,815.39	$11,068.57
Quartz Facility/Professional Professional Modifier Low / Median / High Price $968.91 / $1,327.28 / $12,159.31	Professional		$968.91	$1,327.28	$12,159.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,465.48 / $2,465.48 / $2,465.48	Professional		$2,465.48	$2,465.48	$2,465.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,465.48 / $2,465.48 / $2,465.48	Professional		$2,465.48	$2,465.48	$2,465.48
United Facility/Professional Facility Modifier Low / Median / High Price $3,398.59 / $3,398.59 / $3,398.59	Facility		$3,398.59	$3,398.59	$3,398.59
United Facility/Professional Professional Modifier Low / Median / High Price $829.74 / $1,230.01 / $2,649.26	Professional		$829.74	$1,230.01	$2,649.26