Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,091.09 / $1,091.09 / $1,091.09	Facility		$1,091.09	$1,091.09	$1,091.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $919.61 / $1,091.09 / $1,746.50	Professional		$919.61	$1,091.09	$1,746.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,162.89 / $2,379.17 / $3,936.46	Facility		$2,162.89	$2,379.17	$3,936.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,011.49 / $2,011.49 / $2,660.35	Professional		$2,011.49	$2,011.49	$2,660.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,555.98 / $4,628.58 / $4,628.58	Facility		$1,555.98	$4,628.58	$4,628.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,399.15 / $4,471.83 / $9,028.59	Facility		$1,399.15	$4,471.83	$9,028.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,021.38 / $3,134.53 / $4,093.44	Professional		$1,021.38	$3,134.53	$4,093.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $623.69 / $1,636.65 / $2,487.32	Facility		$623.69	$1,636.65	$2,487.32
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,238.42 / $2,162.89 / $2,595.46	Professional		$1,238.42	$2,162.89	$2,595.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,079.61 / $2,162.89 / $10,269.56	Facility		$1,079.61	$2,162.89	$10,269.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $893.22 / $1,132.99 / $2,357.98	Professional		$893.22	$1,132.99	$2,357.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,006.99	Professional		$50.00	$70.00	$1,006.99
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $623.69 / $1,636.65 / $2,487.32	Facility		$623.69	$1,636.65	$2,487.32
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,238.42 / $2,162.89 / $2,595.46	Professional		$1,238.42	$2,162.89	$2,595.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,162.89 / $3,328.61 / $5,796.37	Professional		$2,162.89	$3,328.61	$5,796.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,399.15 / $4,224.39 / $10,269.56	Facility		$1,399.15	$4,224.39	$10,269.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,021.38 / $1,399.15 / $12,333.02	Professional		$1,021.38	$1,399.15	$12,333.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,162.89 / $2,162.89 / $2,162.89	Professional		$2,162.89	$2,162.89	$2,162.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,162.89 / $2,162.89 / $2,162.89	Professional		$2,162.89	$2,162.89	$2,162.89
United Facility/Professional Professional Modifier Low / Median / High Price $841.04 / $1,079.04 / $2,162.89	Professional		$841.04	$1,079.04	$2,162.89