Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.53 / $1,047.53 / $1,047.53	Facility		$1,047.53	$1,047.53	$1,047.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $893.70 / $1,130.26 / $1,442.83	Professional		$893.70	$1,130.26	$1,442.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,076.54 / $2,284.19 / $3,779.30	Facility		$2,076.54	$2,284.19	$3,779.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,868.88 / $1,931.18 / $2,554.14	Professional		$1,868.88	$1,931.18	$2,554.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,493.86 / $4,443.80 / $4,443.80	Facility		$1,493.86	$4,443.80	$4,443.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,277.46 / $4,292.67 / $8,667.50	Facility		$1,277.46	$4,292.67	$8,667.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $932.55 / $3,009.38 / $3,930.01	Professional		$932.55	$3,009.38	$3,930.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $606.11 / $1,571.30 / $2,388.02	Facility		$606.11	$1,571.30	$2,388.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,188.98 / $2,076.54 / $2,509.19	Professional		$1,188.98	$2,076.54	$2,509.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,047.53 / $2,076.54 / $10,083.62	Facility		$1,047.53	$2,076.54	$10,083.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $868.05 / $1,095.33 / $2,344.40	Professional		$868.05	$1,095.33	$2,344.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,038.65	Professional		$50.00	$70.00	$1,038.65
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $606.11 / $1,571.30 / $2,388.02	Facility		$606.11	$1,571.30	$2,388.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,188.98 / $2,076.54 / $2,509.19	Professional		$1,188.98	$2,076.54	$2,509.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,076.54 / $3,195.74 / $5,633.77	Professional		$2,076.54	$3,195.74	$5,633.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,277.46 / $4,055.74 / $10,083.62	Facility		$1,277.46	$4,055.74	$10,083.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $932.55 / $1,277.46 / $12,143.39	Professional		$932.55	$1,277.46	$12,143.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,076.54 / $2,076.54 / $2,076.54	Professional		$2,076.54	$2,076.54	$2,076.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,658.08 / $2,076.54 / $2,076.54	Professional		$1,658.08	$2,076.54	$2,076.54
United Facility/Professional Professional Modifier Low / Median / High Price $782.38 / $1,085.06 / $1,985.60	Professional		$782.38	$1,085.06	$1,985.60