Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,330.11 / $1,330.11 / $1,330.11	Facility		$1,330.11	$1,330.11	$1,330.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,330.11 / $1,352.00 / $2,567.69	Professional		$1,330.11	$1,352.00	$2,567.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,636.69 / $2,900.36 / $4,798.78	Facility		$2,636.69	$2,900.36	$4,798.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,373.02 / $2,452.12 / $3,243.12	Professional		$2,373.02	$2,452.12	$3,243.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,896.84 / $5,642.52 / $5,642.52	Facility		$1,896.84	$5,642.52	$5,642.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,549.06 / $5,451.18 / $11,006.17	Facility		$1,549.06	$5,451.18	$11,006.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,130.81 / $3,820.78 / $4,990.14	Professional		$1,130.81	$3,820.78	$4,990.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $757.80 / $1,995.17 / $3,032.19	Facility		$757.80	$1,995.17	$3,032.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,509.70 / $2,636.69 / $3,164.03	Professional		$1,509.70	$2,636.69	$3,164.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,311.79 / $2,636.69 / $12,388.80	Facility		$1,311.79	$2,636.69	$12,388.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,162.22 / $1,381.19 / $2,934.57	Professional		$1,162.22	$1,381.19	$2,934.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,634.41	Professional		$50.00	$70.00	$1,634.41
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $757.80 / $1,995.17 / $3,032.19	Facility		$757.80	$1,995.17	$3,032.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,509.70 / $2,636.69 / $3,164.03	Professional		$1,509.70	$2,636.69	$3,164.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,636.69 / $4,057.80 / $7,042.96	Professional		$2,636.69	$4,057.80	$7,042.96
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,549.06 / $5,149.78 / $12,388.80	Facility		$1,549.06	$5,149.78	$12,388.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,130.81 / $1,549.06 / $15,058.46	Professional		$1,130.81	$1,549.06	$15,058.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,636.69 / $2,636.69 / $2,636.69	Professional		$2,636.69	$2,636.69	$2,636.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,636.69 / $2,636.69 / $2,636.69	Professional		$2,636.69	$2,636.69	$2,636.69
United Facility/Professional Professional Modifier Low / Median / High Price $919.10 / $1,315.42 / $2,337.73	Professional		$919.10	$1,315.42	$2,337.73