Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,087.68 / $1,087.68 / $1,087.68	Facility		$1,087.68	$1,087.68	$1,087.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $929.78 / $1,087.68 / $1,765.81	Professional		$929.78	$1,087.68	$1,765.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,156.12 / $2,371.73 / $3,924.14	Facility		$2,156.12	$2,371.73	$3,924.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,005.19 / $2,005.19 / $2,652.02	Professional		$2,005.19	$2,005.19	$2,652.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,551.12 / $4,614.10 / $4,614.10	Facility		$1,551.12	$4,614.10	$4,614.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,184.20 / $4,457.77 / $8,999.20	Facility		$1,184.20	$4,457.77	$8,999.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $864.47 / $3,174.68 / $4,080.64	Professional		$864.47	$3,174.68	$4,080.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $568.52 / $1,631.52 / $2,479.54	Facility		$568.52	$1,631.52	$2,479.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,234.54 / $2,156.12 / $2,587.34	Professional		$1,234.54	$2,156.12	$2,587.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $984.12 / $2,156.12 / $9,758.87	Facility		$984.12	$2,156.12	$9,758.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $858.97 / $1,075.67 / $2,347.75	Professional		$858.97	$1,075.67	$2,347.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,054.46	Professional		$50.00	$70.00	$1,054.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $568.52 / $1,631.52 / $2,479.54	Facility		$568.52	$1,631.52	$2,479.54
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,234.54 / $2,156.12 / $2,587.34	Professional		$1,234.54	$2,156.12	$2,587.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,156.12 / $3,318.21 / $5,283.48	Professional		$2,156.12	$3,318.21	$5,283.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,184.20 / $4,211.18 / $9,758.87	Facility		$1,184.20	$4,211.18	$9,758.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $864.47 / $1,184.20 / $13,813.65	Professional		$864.47	$1,184.20	$13,813.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,156.12 / $2,156.12 / $2,156.12	Professional		$2,156.12	$2,156.12	$2,156.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,721.62 / $2,156.12 / $2,156.12	Professional		$1,721.62	$2,156.12	$2,156.12
United Facility/Professional Professional Modifier Low / Median / High Price $733.85 / $1,075.67 / $2,156.12	Professional		$733.85	$1,075.67	$2,156.12