Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,204.18 / $1,204.18 / $1,204.18	Facility		$1,204.18	$1,204.18	$1,204.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,087.85 / $1,204.18 / $2,066.03	Professional		$1,087.85	$1,204.18	$2,066.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,387.05 / $2,625.76 / $4,344.43	Facility		$2,387.05	$2,625.76	$4,344.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,148.34 / $2,219.96 / $2,936.07	Professional		$2,148.34	$2,219.96	$2,936.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,717.24 / $5,108.29 / $5,108.29	Facility		$1,717.24	$5,108.29	$5,108.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,544.16 / $4,935.26 / $9,963.50	Facility		$1,544.16	$4,935.26	$9,963.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,127.24 / $3,459.38 / $4,517.68	Professional		$1,127.24	$3,459.38	$4,517.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $648.64 / $1,806.27 / $2,745.11	Facility		$648.64	$1,806.27	$2,745.11
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,366.77 / $2,387.05 / $2,864.46	Professional		$1,366.77	$2,387.05	$2,864.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,122.82 / $2,387.05 / $10,889.05	Facility		$1,122.82	$2,387.05	$10,889.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $950.97 / $1,195.13 / $2,599.19	Professional		$950.97	$1,195.13	$2,599.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $1,001.74	Professional		$50.00	$70.00	$1,001.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $648.64 / $1,806.27 / $2,745.11	Facility		$648.64	$1,806.27	$2,745.11
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,366.77 / $2,387.05 / $2,864.46	Professional		$1,366.77	$2,387.05	$2,864.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,387.05 / $3,673.59 / $6,028.22	Professional		$2,387.05	$3,673.59	$6,028.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $1,544.16 / $4,662.20 / $10,889.05	Facility		$1,544.16	$4,662.20	$10,889.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,127.24 / $1,544.16 / $14,954.09	Professional		$1,127.24	$1,544.16	$14,954.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,387.05 / $2,387.05 / $2,387.05	Professional		$2,387.05	$2,387.05	$2,387.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,387.05 / $2,387.05 / $2,387.05	Professional		$2,387.05	$2,387.05	$2,387.05
United Facility/Professional Professional Modifier Low / Median / High Price $837.28 / $1,190.86 / $2,387.05	Professional		$837.28	$1,190.86	$2,387.05