Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,945.38 / $1,945.38 / $1,945.38	Facility		$1,945.38	$1,945.38	$1,945.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,841.28 / $2,018.79 / $3,000.13	Professional		$1,841.28	$2,018.79	$3,000.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,856.33 / $4,241.96 / $7,018.52	Facility		$3,856.33	$4,241.96	$7,018.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,335.34 / $3,586.39 / $4,743.28	Professional		$3,335.34	$3,586.39	$4,743.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,774.23 / $8,252.54 / $8,252.54	Facility		$2,774.23	$8,252.54	$8,252.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,326.75 / $8,514.58 / $16,096.39	Facility		$2,326.75	$8,514.58	$16,096.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,698.53 / $5,588.44 / $7,298.41	Professional		$1,698.53	$5,588.44	$7,298.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,109.53 / $2,918.07 / $4,434.78	Facility		$1,109.53	$2,918.07	$4,434.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $2,208.05 / $3,763.92 / $4,627.60	Professional		$2,208.05	$3,763.92	$4,627.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,920.65 / $3,856.33 / $17,957.82	Facility		$1,920.65	$3,856.33	$17,957.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,683.93 / $2,020.08 / $4,199.07	Professional		$1,683.93	$2,020.08	$4,199.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,602.46	Professional		$50.00	$70.00	$2,602.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,109.53 / $2,918.07 / $4,434.78	Facility		$1,109.53	$2,918.07	$4,434.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $2,208.05 / $3,763.92 / $4,627.60	Professional		$2,208.05	$3,763.92	$4,627.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,856.33 / $5,934.76 / $10,312.01	Professional		$3,856.33	$5,934.76	$10,312.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,326.75 / $7,531.90 / $17,957.82	Facility		$2,326.75	$7,531.90	$17,957.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,698.53 / $2,326.75 / $19,415.13	Professional		$1,698.53	$2,326.75	$19,415.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,856.33 / $3,856.33 / $3,856.33	Professional		$3,856.33	$3,856.33	$3,856.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,856.33 / $3,856.33 / $3,856.33	Professional		$3,856.33	$3,856.33	$3,856.33
United Facility/Professional Professional Modifier Low / Median / High Price $1,432.22 / $1,923.88 / $3,674.64	Professional		$1,432.22	$1,923.88	$3,674.64