Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,955.49 / $1,955.49 / $1,955.49	Facility		$1,955.49	$1,955.49	$1,955.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,677.67 / $1,955.49 / $3,186.19	Professional		$1,677.67	$1,955.49	$3,186.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,876.39 / $4,264.03 / $7,055.03	Facility		$3,876.39	$4,264.03	$7,055.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,352.68 / $3,605.04 / $4,767.95	Professional		$3,352.68	$3,605.04	$4,767.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,788.67 / $8,295.46 / $8,295.46	Facility		$2,788.67	$8,295.46	$8,295.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,507.59 / $8,014.03 / $16,180.36	Facility		$2,507.59	$8,014.03	$16,180.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,830.54 / $5,617.50 / $7,336.38	Professional		$1,830.54	$5,617.50	$7,336.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,137.80 / $2,933.24 / $4,457.85	Facility		$1,137.80	$2,933.24	$4,457.85
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,219.53 / $3,876.39 / $4,710.32	Professional		$2,219.53	$3,876.39	$4,710.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,955.49 / $3,876.39 / $18,505.52	Facility		$1,955.49	$3,876.39	$18,505.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,629.53 / $2,056.19 / $4,376.38	Professional		$1,629.53	$2,056.19	$4,376.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,091.34	Professional		$50.00	$70.00	$1,091.34
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,137.80 / $2,933.24 / $4,457.85	Facility		$1,137.80	$2,933.24	$4,457.85
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,219.53 / $3,876.39 / $4,710.32	Professional		$2,219.53	$3,876.39	$4,710.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,876.39 / $5,965.64 / $10,574.98	Professional		$3,876.39	$5,965.64	$10,574.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,507.59 / $7,571.08 / $18,505.52	Facility		$2,507.59	$7,571.08	$18,505.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,830.54 / $2,507.59 / $28,060.61	Professional		$1,830.54	$2,507.59	$28,060.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,876.39 / $3,876.39 / $3,876.39	Professional		$3,876.39	$3,876.39	$3,876.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,876.39 / $3,876.39 / $3,876.39	Professional		$3,876.39	$3,876.39	$3,876.39
United Facility/Professional Professional Modifier Low / Median / High Price $1,379.98 / $1,933.89 / $3,706.62	Professional		$1,379.98	$1,933.89	$3,706.62