Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,175.34 / $1,175.34 / $1,175.34	Facility		$1,175.34	$1,175.34	$1,175.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,112.45 / $1,175.34 / $2,112.75	Professional		$1,112.45	$1,175.34	$2,112.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,329.91 / $2,562.90 / $4,240.43	Facility		$2,329.91	$2,562.90	$4,240.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,619.40 / $2,166.82 / $2,865.78	Professional		$1,619.40	$2,166.82	$2,865.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,676.14 / $4,986.01 / $4,986.01	Facility		$1,676.14	$4,986.01	$4,986.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,300.55 / $4,817.04 / $9,725.57	Facility		$1,300.55	$4,817.04	$9,725.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $949.40 / $3,880.39 / $4,409.54	Professional		$949.40	$3,880.39	$4,409.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $670.35 / $1,763.03 / $2,679.40	Facility		$670.35	$1,763.03	$2,679.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,334.05 / $2,274.06 / $2,795.89	Professional		$1,334.05	$2,274.06	$2,795.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,160.41 / $2,329.91 / $10,889.80	Facility		$1,160.41	$2,329.91	$10,889.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,017.39 / $1,220.49 / $2,536.98	Professional		$1,017.39	$1,220.49	$2,536.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,517.14	Professional		$50.00	$70.00	$1,517.14
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $670.35 / $1,763.03 / $2,679.40	Facility		$670.35	$1,763.03	$2,679.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,334.05 / $2,274.06 / $2,795.89	Professional		$1,334.05	$2,274.06	$2,795.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,329.91 / $3,585.65 / $6,229.97	Professional		$2,329.91	$3,585.65	$6,229.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,300.55 / $4,550.60 / $10,889.80	Facility		$1,300.55	$4,550.60	$10,889.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $949.40 / $1,300.55 / $11,730.04	Professional		$949.40	$1,300.55	$11,730.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,329.91 / $2,329.91 / $2,329.91	Professional		$2,329.91	$2,329.91	$2,329.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,329.91 / $2,329.91 / $2,329.91	Professional		$2,329.91	$2,329.91	$2,329.91
United Facility/Professional Professional Modifier Low / Median / High Price $813.03 / $1,162.36 / $2,065.73	Professional		$813.03	$1,162.36	$2,065.73